Corneal Transplant
Corneal transplantation has been the most successful organ transplant (also known as graft) procedure because of the low risk of graft rejection. The cornea is the transparent layer on the eye which allows light to enter the eye and is also known as the ‘window of the eye’. A donor cornea obtained from a deceased donor (who has generously donated the cornea) is used for the transplant.
Indications for corneal transplant
Corneal transplants are performed for the following reasons;
- to restore vision caused by scarring or cloudiness due to cornea injury or disease such as Fuchs Endothelial Dystrophy or Keratoconus
- to reduce pain due to corneal injury or oedema from previous surgery, inflammation or trauma
- to remove corneal ulcer infection which is not improving with medication
- to repair a perforated cornea due to injury or infection
- to improve cosmetic appearance of the eye due to corneal scaring which looks white or grey
Common Types of Corneal Transplant Procedures
- Penetrating Keratoplasty (PKP) is where the whole cornea is replaced and sutured into position using sutures (stitches) to replace the whole damaged cornea
- Lamellar Keratoplasty such as DALK (Deep Anterior Lamellar Keratoplasty) replaces the outer half of the cornea caused by scarring or thinning due to ulcers or injury
- Endothelial Keratoplasty such as DSAEK (Descemet’s Stripping Automated Endothelial Keratoplasty) or DMEK (Descemet’s Membrane Endothelial Keratopasty) replaces the inner thin layer of endothelial cells which are vital for the health of the cornea. These endothelial cells pump fluid out of the cornea to keep the cornea dry and transparent
Click to view SydWestEyes video on Corneal Transplant
Potential Risks
- Primary graft failure can occur in up to 5% of cases
- Graft rejection can occur anytime so you need to apply medication as directed by your doctor
- Graft dislocation or wound leak
- Endothelial cell loss over time
- Infection
Follow up Care after Corneal Transplant
- You should refrain from physical activities or contact sports for 3-4 weeks
- Apply the medication as directed by your doctor to reduce the risk of infection and graft rejection
- Wear the eye shield for the first few days to prevent accidental injury
- The visual recovery varies depending on the type of corneal transplant and severity of your eye condition. In general, vision gradually improves from around 2 weeks to 2 months and may take up to 6 months to stabilise
Follow-up Check Up with your Eye Doctor
It is important to have regular eye checks with your doctor and to strictly comply with the usage of medications (usually eye drops) prescribed to reduce the risk of complications. At each check up, your doctor will examine to;
- Ensure the graft is healing well and look for signs of graft rejection
- Measure eye pressures to look for steroid-induced eye glaucoma
- Assess the endothelial cell count on the cornea
- Measure the corneal thickness and curvature
- Measure the prescription and refraction of your vision
- Advise you on the medication usage
Discuss your Treatment Options for your corneal condition with a Corneal Eye Specialist
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