Corneal Transplant Surgery

Cornea is the outermost window of the eye. It being a transparent structure, allow light rays to get focused on the retina. Hence, one can see sharp and clear images.

Corneal problems can happen to anyone at any age. Injury, diseases, infections and nutritional deficiencies can lead to clouding or scarring of cornea. Diseased and damaged cornea stops functioning as transparent window to the eye. This not only causes defective vision, but it may cause pain and other symptoms also.

When other option for treatment is not available, the doctor may consider transplanting a cornea.

What is corneal Transplant?

In corneal transplantation procedure A diseased cornea is replaced by a healthy donor cornea.

For this, one has to depend upon donation of human eyes. The eyes are donated after death and the eye bank processed these human corneas before transplantation.

Corneal transplantation is one of the most common and most successful transplantation procedure amongst all the other organ transplants. What should be done for getting a corneal Transplant?

With the help of corneal surgeon an individual needs to register one’s name to receive a corneal tissue at the bank or with the hospital. On availability of a suitable tissue, the patients are intimated telephonically about the surgery.

Before the surgery detailed eye examination is done by the consultant. Certain tests are performed and a physical fitness and lab investigations are must. As the tissue must be transplanted within certain time limit, it is necessary that one should respond immediately on receiving the phone call. Surgery is generally done under local anesthesia, but few cases may require either general anesthesia or sleep including medications.

Sometimes, along with the transplant other associated surgical procedures may be performed and/or you may require them in the post-operative period depending upon the recovery/progress. For example, a cataract may be removed and replaced with an intra ocular lens(IOL). An IOL may be replaced or removed. The vitreous gel may be removed from the eye and replaced with fluid. A damaged iris may be repaired.

One may have to stay in the hospital for couple of days or stay at local address for 1 week or so, as the initial few weeks are most crucial for over all outcome.

Some Facts:

The race, gender and the eye color of the donor’s cornea are not important

  1. A corneal transplant may not change your eye color
  2. It is not necessary to match the blood of the donor

Corneal graft takes longer time to stabilize as the graft is stitched all around plus the healing of every individual varies. Hence, astigmatism is common after the surgery. However, it can be corrected. Usually stitches of a graft are adjusted or removed at 1 year or even later. Till then one can use temporary visual correction in the form of glasses.

Care after surgery:

  1. One should not lift heavy things
  2. One should not bend so that the head is lower than the waist
  3. Avoid sleeping on the operated side
  4. Refrain from strenuous activity
  5. Always use protective glasses and avoid injury to the eye
  6. Watch television for every short while only
  7. You can clean the eye gently with sterilized cotton for first 4-8 weeks

Associated risks: As with other surgical procedures, a corneal transplant involves some risks, but most of them can be treated.

Some possible complications are infections, failure of the donor cornea to function normally, rejection of the donor cornea by your body, cataract development, and hemorrhage, development of glaucoma, swelling or detachment of retina.

Rejection of Transplant:

Rejection of a transplanted cornea can occur at any time, but is more likely to happen in the first year after surgery. Unfortunately, rejection reduces the chance of success of any repeat corneal transplantation. However, it can be prevented by timely diagnosis and appropriate management.

So, watch out for these danger signals:
Redness
Sensitivity to light
Vision loss

Pain-

The acronym ‘RSVP’ can help you remember these symptoms. If you notice any of these symptoms in your operated eye, however minor they may seem, contact nearest ophthalmologist (eye specialist) preferably a cornea specialist.

Medication and follow-up:

Please follow the instructions regarding medications carefully. For first 2 years it is mandatory to have check-ups every 4-6 weeks with your operating surgeon. First 2 years post surgery is most crucial for overall long term survival of the grafts. Later on, 6 monthly to yearly follow-ups are sufficient to ensure the grafts health. For emergency help kindly specify the seriousness of the problem, so that reception staff can accommodate you. Always mention your medical record number and name in your communications.

Overall success of a corneal transplant is around 80%. Technical success of a graft can be maintained only with combined efforts of the doctor as well as patients. One must understand the long term care involved with such procedures.

The credit of an improvement in the sight of the patient goes to many, the corneal surgeon for technical skill and knowledge, eye bank staff and the eye donor family.