Eye Diseases What is Corneal Transplantation?

In Corneal Transplant (Keratoplasty) the diseased cornea is replaced with a healthy donor cornea. Corneal transplant is done for cases where the corneal condition or clarity (Opacity, Degeneration, Dystrophy, Thinning & Irregularity) does not allow light to pass through it and focus on the retina, in an attempt to restore vision. Corneal Grafting is also done in cases where there is severe corneal infection or injury, so as to try and save the eye. In such cases the primary goal of surgery is to save the anatomical structure of the eye (Therapeutic Keratoplasty). The replacement of the cornea can either be full thickness (Penetrating Keratoplasty) or partial thickness (Lamellar Keratoplasty), depending on the condition of the patient's diseased cornea.

What happens after the decision for a Corneal Transplant is taken?

The patient's name will be included in an Eye Transplant waiting list. All the required information like the age, type of corneal diseases and urgency of the transplant will be listed. The most important thing the patient should furnish is the contact details like address and phone numbers, and the patient shall be contacted when a donor cornea is available and that his name has come up on the list.

From where does the cornea come?

Human tissue cannot be manufactured in factories. If someone needs a new cornea, someone has to donate it. After Eye Donation (link), these donated corneas are collected, evaluated, processed and distributed by the Eye Bank

What is the Success Rate for Corneal transplants?

The success rate varies with various factors like the patient's age, donor corneal quality, pre-existing disease, surgical technique and skills etc. But it just suffices to state that Corneal Transplant is the most successful of all transplant surgeries. Corneal Graft Rejection is less common because there are almost no blood vessels in the cornea.

What are the Warning Signals after a Corneal Transplant?

If the patient's body begins to reject the transplant or if any other problems occur, the situation can often be remedied if the patient contacts the doctor immediately. If a graft does fail, another cornea transplant may performed. Transplant recipients must watch for the following conditions -

A.Redness of the eye -
For the first few weeks after surgery, the eye will be red and become less red as time goes on. However, any substantial increase in redness or redness after recovery is cause to contact the doctor.

B. Sensitivity to Light -
Some light sensitivity after surgery is expected and it should gradually decrease. If the eye becomes more sensitive to light than usual, the doctor should be notified.

C. Vision Loss -
Patients are advised to select an object at home to test their vision on every day. Changes in vision are expected, but if the check point appears more cloudy or blurred than in previous checks, the doctor must be called.

D. Pain -
Small twinges of pain during the healing process are expected. But the doctor must be notified if the eye hurts or throbs steadily for more than two or three hours.

What is the Usual Course after a Corneal Transplant?

How well a corneal transplant works depends on each individual & the conditions affecting his or her eyes. A successful corneal transplant requires care & attention from both patient and physician. A patient who has undergone a corneal transplant must routinely & regularly follow up with his surgeon, even if he or she has no complaints.

Recovery varies from patient to patient, however, for most vision gradually improves over time. Stitches are generally removed after several months or upto 3 years after surgery. In certain cases the stitches may not be removed at all. Vision usually stabilizes after about one year, at which time glasses are usually prescribed.

What are the Possible Complications in Corneal Transplantation?

In-spite of best efforts the transplanted cornea may suffer from Graft Failure due to Rejection or Infection. These may result in loss of vision in the operated eye and opacification of the graft, which may cause pain and or cosmetic blemish making the eye or cornea look white. In-spite of a clear corneal graft after surgery the patient may not have an improvement in vision due to Astigmatism, Cataract, Glaucoma, Media Opacity, Retinal or Optic nerve problems. It is not always possible to predict these problems before surgery. After Corneal transplants it is a well-known fact that there may be development of Cataract and or Glaucoma. To try and prevent or manage these complications it is very important for the patient to be seen regularly and the patient will need multiple visits in the first 12 to 18 months. Even after that the patient must be followed up at least once in 3 to 6 months, or as advised by the doctor. It would be the patient's responsibility to maintain follow up appointment necessary after the surgery. The patient may require multiple minor or major procedures after the transplant.