A corneal transplant is an operation, also called keratoplasty, to replace part of your cornea with tissue from a donor. The cornea is the clear, rounded surface of your eye, and it’s what allows the eye to focus. If you have had an eye disease or disorder that affects the cornea, a corneal transplant may be the right option for you.
There are several issues with the cornea that can be helped with transplanted corneal tissue, including scarring, cloudiness, inflammation, or thinning of the cornea, or corneal ulcers, bulging corneas, or a disorder called Fuch’s dystrophy, which is an inherited condition that causes swelling and clouding. Your eye doctor will help you decide if you are a good candidate for corneal transplant surgery.
A corneal transplant is a relatively safe operation, but like any surgery, it carries some risks, including infection, inflammation, or issues with the stitches. In addition, there is a chance that, as can sometimes happen in transplant surgeries, your body may reject the transplanted tissue. Statistically, this happens in approximately 20% of cases. The immune system reacts against the new tissue, causing such symptoms as pain, redness, light sensitivity, or loss of vision. If you experience any of these signs that your eye is rejecting the donor tissue, see your doctor for treatment and to discuss whether having a second transplant is an appropriate option.
Preparing for surgery
Prior to having the operation, you will have a thorough eye examination, so your doctor can look for anything that might cause complications during or after the procedure. He or she will measure your eye and assess how much corneal donor tissue you might need. You will be asked to provide a list of all medications and supplements you take, as you may need to stop using some of them before the operation. If you have any other concerns with your eyes that could affect the success of the transplant, your doctor will provide treatment for those first, before you can undergo the operation.
Your surgical team will also work to match you with an appropriate donor. Patients in need of donor corneal tissue usually do not need to wait as long as those awaiting liver or kidney transplants, for example, as many donors specifically request to donate corneal tissue upon their death.
On the day of the procedure, the team will give medicine to help you relax, as well as a local anaesthetic to numb the area. You won’t be put under, but you should not feel any pain during the operation. Then, to put it in the simplest terms, the surgeon will cut out the diseased or afflicted bit of cornea and replace it with the donor tissue, then stitch it into place. The procedure can vary in terms of how much of the original tissue is removed; your doctor will discuss all of the details with you.
After the transplant
Once the operation is done, you’ll be given eye drops (and sometimes tablets) right away to help prevent infection, reduce swelling, and manage pain. You may also have an eye patch to help protect the eye during recovery. It’s important you continue to take precautions not to expose the eye to injury – not just after the procedure but for the rest of your life.
You should take enough time to rest and heal after the transplant, and pace yourself as you resume your daily activities, including driving, working, and exercising. You’ll have frequent follow-up examinations in the year following your surgery, so be sure to report any pain or other unusual symptoms at your next appointment or sooner, if necessary.
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