Eye Conditions

What is a Corneal Transplant?

A corneal transplant involves replacing all or part of the cornea with a healthy donor cornea. The cornea is the clear, transparent layer at the front of the eye that helps focus light and provides clear vision. When the cornea becomes cloudy or distorted due to disease or injury, a transplant can restore normal vision.

Why Might You Need a Corneal Transplant?

The cornea’s primary function is to allow light to enter the eye and focus it onto the retina for clear vision. Diseases or injuries that affect the cornea can lead to cloudiness or irregular shape, disrupting light passage and impairing vision. Replacing the damaged cornea with a healthy donor cornea can help restore clarity.

Types of Corneal Transplants

Modern corneal transplantation aims to replace only the affected layer(s) of the cornea, preserving the healthy parts. The cornea has three main layers: an outer layer, a middle layer, and an inner layer. Depending on the condition, different types of transplants may be performed:

• Deep Anterior Lamellar Keratoplasty (DALK): This involves replacing only the outer and middle layers of the cornea while preserving the inner layer. DALK is commonly used for conditions like keratoconus and some corneal dystrophies. It helps maintain corneal structure and reduces the risk of graft rejection.
• Endothelial Keratoplasty (EK): Known as Descemet’s Membrane Endothelial Keratoplasty (DMEK) or Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK), this procedure replaces only the inner layer of the cornea. It is used for conditions like Fuch’s endothelial dystrophy and pseudophakic bullous keratopathy. This method preserves the cornea's front surface and typically offers quicker recovery.
• Penetrating Keratoplasty (PK): This full-thickness transplant replaces all three layers of the cornea with a donor cornea. It is used when the entire thickness of the cornea is affected by disease.

What to Expect During Corneal Transplant Surgery

Corneal transplant surgery is usually performed as a day procedure, lasting about 1 to 2 hours. It can be done under local or general anesthesia, depending on the type of transplant and your preferences. The procedure involves removing the diseased layer(s) of the cornea and replacing them with donor tissue, which is then secured in place with sutures or, in the case of endothelial keratoplasties, an air bubble.

Post-Surgery Care and Recovery

After surgery, you’ll typically go home the same day, though it’s advisable to have someone drive you. Follow-up appointments are usually scheduled for 1 day, 1 week, and then periodically over the first year. You will be prescribed antibiotic and anti-inflammatory drops to prevent infection and aid healing. The antibiotic drops are usually for 7 days, while anti-inflammatory drops are used longer to minimize the risk of graft rejection.

Visual Recovery

Recovery time varies depending on the type of corneal transplant performed. Partial-thickness transplants generally have a quicker recovery compared to full-thickness transplants. Your ophthalmologist will provide detailed information on what to expect during your recovery period.