Corneal Transplant
(Keratoplasty; Penetrating Keratoplasty)
Definition
Corneal transplant is a surgical procedure used to replace a portion of a diseased or damaged cornea with a healthy one. The cornea is the clear, outer surface on the front of the eye.
Cornea of the EyeCopyright © Nucleus Medical Media, Inc. |
Reasons for Procedure TOP
A corneal transplant can correct vision problems caused by infections, injuries, or medical conditions that affect the cornea. It is often recommended for the following:
- Keratoconus—a thinning and bulging of the cornea that causes blurred vision
- A cornea scarred from infection or injury
- Clouding of the cornea
- Complications of previous eye surgery
Possible Complications TOP
The procedure is usually highly successful. Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Rejection of the new cornea—the body’s defense system attacks the new tissue, damaging it
- Glaucoma
- Problems focusing
- Light sensitivity
- Swelling or detachment of the retina
- Cataract
- Infection
- Bleeding
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications, such as:
The operation is most successful for those who have the following:
- Keratoconus
- Corneal scars
- Corneal dystrophies
It is less successful for those who have corneal infection and severe injury, like a chemical burn.
What to Expect TOP
Prior to Procedure
Your ophthalmologist may do a physical exam and blood tests.
Before the procedure:
- Talk to your doctor about your medications. Also, discuss any herbs or vitamins you take. You may be asked to stop taking some medications up to 1 week before the procedure.
- Arrange to have someone drive you home.
- Arrange for help at home after the procedure.
- Use any eye drops as instructed by your eye surgeon.
- The day before, do not eat or drink anything after midnight unless told otherwise by your doctor.
Anesthesia
2 types of anesthesia can be used during a corneal transplant:
- Local anesthesia to numb the eye
- General anesthesia
Description of Procedure TOP
The procedure will be done under a surgical microscope. The damaged part of the cornea will be cut out. The new cornea will then be placed in the opening. The new cornea will be fastened with very fine stitches. Finally, a patch and shield will be put over the eye.
There is another technique called Descemets stripping endothelial keratoplasty (DSEK). DSEK is used for some types of cornea transplants. It may result in shorter recovery time and better vision. With this technique, the doctor removes a much smaller part of the cornea, compared with older procedures.
How Long Will It Take? TOP
1-2 hours
How Much Will It Hurt? TOP
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
Average Hospital Stay TOP
You will most likely go home after a few hours in the recovery area.
Post-procedure Care TOP
At Home
Recovery at home includes pain management and avoiding certain activities until the eye heals. Other recovery steps may include:
- Using eye drops
- Wearing glasses during the day or a shield at night
- Not rubbing the eye
- Protecting the eye from accidental bumps or pokes
- Avoiding contact sports
Vision may initially be worse than before your surgery before your eye adjusts to the new cornea. It may take several months for it to improve. Stitches are usually left in place for several months. Regular follow-up visits will allow the doctor to monitor how the eye is healing. Do not drive until your doctor says you can.
Call Your Doctor TOP
Contact your doctor if your recovery is not progressing as expected or you develop complications, such as:
- Signs of infection, including fever and chills
- Vision symptoms, including decreased vision, floaters, flashing lights, increased light sensitivity, or loss of peripheral vision
- Increased eye redness
- Increased pain
- Persistent nausea or vomiting
If you think you have an emergency, call for medical help right away.
RESOURCES:
Eye Bank Association of America
http://www.restoresight.org
National Keratoconus Foundation
http://www.nkcf.org
CANADIAN RESOURCES:
Canadian National Institute for the Blind
http://www.cnib.ca
Canadian Ophthalmological Society
http://www.cos-sco.ca
REFERENCES:
Corneal transplants. National Keratoconus Foundation website. Available at:
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Accessed December 14, 2017.
Facts about the cornea and corneal disease. National Eye Institute website. Available at: https://nei.nih.gov/health/cornealdisease. Updated May 2013. Accessed December 14, 2017.
Frequently asked questions. Eye Bank Association of America website. Available at:
...(Click grey area to select URL)
Accessed December 14, 2017.
Williams K, Irani Y, Klebe S. Novel therapeutic approaches for corneal disease. Discov Med. 2013 May;15(84):291-9. Available at:
...(Click grey area to select URL)
Accessed January 3, 2018.
Last reviewed November 2018 by
EBSCO Medical Review Board
Michael Woods, MD, FAAP
Last Updated: 12/20/2014