A corneal transplant (also known as keratoplasty) is the replacement of the cornea of the eye with a cornea from a deceased individual. Corneal transplantation is the most common type of transplantation surgery performed. It is also one of the safest.
What is the cornea?
The cornea is the clear covering on the front of the eye. It functions to protect the inside of the eye, as well as to help focus light. If the cornea becomes cloudy or malformed, there will likely be decreased vision.
Diagram showing the location of the cornea in the eye.
Why would a corneal transplantation be performed?
If non-surgical treatments are insufficient at reversing vision loss from corneal problems, a transplant may be required. Some common reasons for corneal transplantation include:
• Injury • Infection • Eye diseases that affect the cornea
The diagram shows a corneal ulcer (the white spot on the cornea). When corneal ulcers are severe, a corneal transplant may be required. You can read more about corneal ulcers by click here.
What type of anesthesia is used for surgery?
The type of anesthesia used for surgery depends on many factors, including characteristics of the patient and the reason for surgery. Usually, corneal transplantation is performed under local anesthesia along with a sedative (only the eye and its surroundings are “frozen”). Occasionally, however, it is performed under general anesthesia (the patient is fully asleep and cannot feel anything).
What happens during surgery?
Once the patient is ready for surgery, a disc of corneal tissue from the eye is removed. Usually, this disc comprises the full thickness of the cornea, but in some cases only the outer or inner layers are removed.
Next, the donor cornea is sutured in place on the patient’s eyes. These sutures are extremely fine, thinner than a strand of human hair. The entire surgery takes between 1 and 2 hours.
Diagram showing the outcome of corneal transplant surgery. The new corneal graft is held in place by sutures.
Who performs a corneal transplantation?
A corneal transplantation is performed by an ophthalmologist who has had extra training in a field called cornea and external diseases. Our cornea specialist at Queen’s is Dr. Baxter.
What happens after surgery?
Most patients having a corneal transplant return home the same day of surgery. However, they need to be seen in follow-up the following day, one week later, and monthly for about the first year. Ongoing follow-up will be needed for their lifetime to monitor the health of the transplant.
What are the long-term results of a corneal transplantation?
Most patients having a corneal transplantation will have at least some of their vision restored. In some cases, the success rate is as high as 95%.
However, like any surgery there are complications that can occur from surgery. The most common complications are cataracts, glaucoma and retinal detachments. In some patients, a graft rejection may occur; this means that the body’s immune system attacks the donor cornea.
Fortunately, many of these complications are treatable. However, it is still important to discuss potential side effects or complications with your doctor before the surgery.
