Corneal transplant

The cornea is the clear front window of the eye. It transmits light to the interior of the eye allowing us to see clearly. The cornea is a curved surface. Light is refracted (bent) through this surface, onto the retina, producing a clear image.

Corneal injury, disease, or hereditary conditions can cause clouding, distortion and scarring. Corneal clouding blocks the clear passage of light to the back of the eye, reducing sight sometimes even to the point of blindness. In addition, corneal injury and disease can be painful, sometimes the most intense pain we can experience.

If the cornea becomes cloudy, the only way to restore sight is to replace or transplant the cornea. Corneal transplantation (keratoplasty) is the most successful of all tissue transplants. The success rate depends on the cause of the clouding. For example corneal transplants for degeneration following cataract surgery and those for keratoconus both have high success rates, while corneal transplants for chemical burns have lower success rates.

How are corneal transplants done?

Corneal tissue for transplant comes from an eye bank. The process begins at the death of someone who has been generous enough to be a donor. Names of patients needing corneal transplants are placed on a waiting list until tissue is available. The operation consists of a transfer of the clear central part of the cornea from the donor's eye to the patient's eye. For best results the donor cornea must be used promptly. We will contact you when a cornea becomes available and generally surgery will take place within 24 hours of being notified.

What happens after surgery?

The day after surgery the patch is removed. From this time you no longer require a patch but will need a pair of sunglasses to prevent glare, and you will need to wear a small plastic shield at night to protect your eye while asleep. The eye will be red and watery for about two weeks.

Follow up after surgery?

After corneal transplantation you need to be seen at regular intervals. Post-operative visits are normally scheduled for one week, one month, and then approximately every three months after surgery. You require drops throughout this period and instruction will be given as to their use.

Are there any risks?

Any surgery entails some risks of infection and haemorrhage. These are rare with ocular microsurgery. A donor cornea is used for transplantation and so there is a risk of rejection. If this occurs the eye may become red or painful and your vision will deteriorate. If so, you must seek help promptly as most rejection episodes can be successfully handled if treated early.

Do the sutures need to be removed?

Yes. This is done in the office after a drop of local anaesthetic. The time for suture removal will vary depending on the eye disease, but is never before six months, and will occasionally be longer than twelve months. The sutures are buried and you do not feel them in the post-operative period.

How quickly will my vision recover?

This depends on the reason for the surgery. The cornea achieves a stable shape by eight weeks, but final best vision is often not achieved until after the sutures are removed.