A corneal transplant is a procedure in which a cloudy, scarred, or misshaped cornea is removed and replaced with a clear, donated cornea. The cornea is the clear outer layer on the front of the eye. Penetrating keratoplasty is another name for this procedure.
The surgery is done to improve your vision. Corneal problems that cause corneal clouding or decreased vision include:
Corneas for transplant come from other people who have donated their corneas when they die. An eye bank examines, protects, and stores the donated corneas. Before a donated cornea is used, it is tested for clarity and diseases. Only clear, healthy corneas are used.
Do not eat or drink anything for several hours before the procedure. This will prevent nausea and vomiting. Depending on what time you are having your procedure, your healthcare provider will tell you what time to stop eating and drinking.
You may or may not need to take your regular medicines the day of the procedure, depending on what they are and when you need to take them. Tell your healthcare provider about all medicines and supplements that you take.
Some medicines (like aspirin) may increase your risk of bleeding during or after the procedure. Ask your healthcare provider if you should stop taking any of your medicine before the procedure.
If you smoke, it is best to quit 6 to 8 weeks before surgery. Smokers don't heal as fast as people who don't smoke. Smokers may have breathing problems during the procedure.
Plan for your care and a ride home after the procedure. Also plan for your recovery at home.
Do not wear eye makeup on the day of the surgery. Follow any other instructions provided by your provider.
Often a general anesthetic is used. A general anesthetic relaxes your muscles, puts you to sleep, and prevents you from feeling pain. Sometimes a local anesthetic and sedative are used instead. The local anesthetic numbs the eye and the sedative relaxes you.
The center of the cloudy or damaged cornea—an area about the size of a dime—is removed. Then the clear center of a donated cornea is sewn into its place using stitches that will be removed later. If your eye has a cataract, the cataract can be removed at the same time.
In a newer type of corneal transplant, only the deeper layers (and sometimes only a single layer) of the cornea are removed and replaced with donor tissue. Ask your provider if you are a candidate for these procedures.
Your eye care provider will put a patch over your eye. You will be able to go home when you are fully awake, 1 to 2 hours after the surgery.
Your provider will examine your eye the next day. There is usually very little discomfort after surgery. You may feel like you have something in your eye for a few days.
Avoid bending, heavy lifting, and exercise for at least 2 weeks. Wear glasses or a shield at all times to protect your eye. You will use eyedrops several times a day for a long time. They help prevent infection and rejection of the new cornea.
As the eye heals, some of the tiny stitches used to sew the transplant in place may be removed. This is done easily and painlessly in your provider's office. The stitches may be removed as early as a month after surgery or up to a year later. Sometimes the stitches are left in place permanently. Sometimes a stitch may break or loosen on its own. You will feel like there is an eyelash under the lid. You should let your provider know because it may need to be removed.
It takes time for good vision to return after this surgery. You will probably get new glasses or contact lenses 4 to 6 months after surgery.
Sometimes an eye has some astigmatism after surgery. This means the cornea is uneven. Sometimes this is due to the stitches used during corneal transplant surgery and can be fixed by removing some of the stitches. Astigmatism can cause blurred vision, but glasses or contact lenses usually can correct it. In the few cases where there is too much astigmatism to correct with glasses or contacts, more surgery may help.
Rarely, a serious infection or bleeding can permanently damage your eyes. Your eye care provider will take every possible precaution to prevent this.
If the eye is injured after a corneal transplant, it can cause more severe damage than injury to an eye without a transplant. This is because the stitches are not as strong as natural tissue.
A few people with corneal transplants have a graft failure. This means that the transplanted cornea becomes too cloudy to allow good vision. This may happen, for example, because the body rejects the new cornea. Uncontrolled high pressure in the eyes, a history of inflammation in the cornea, and abnormal blood vessels in the cornea are some things that increase the risk of graft failure.
Call the provider right away if you have:
