The cornea is a clear layer at the front of the eye and helps you to see clearly by focusing light. Eye disease or injury may cause your cornea to become misshapen, swollen, or scarred and negatively impact on your vision.
If you experience a lot of painful swelling or find the use of eyeglasses or contact lenses can’t correct your vision, a corneal eye transplant may be necessary.
An eye cornea transplant removes unhealthy or damaged corneal tissue from the eye and replaces it with donated tissue from a local eye bank. This can be done with a traditional cornea transplant, replacing the full thickness (penetrating keratoplasty), or just the back layer (endothelial keratoplasty).
You and your eye doctor should discuss the procedure thoroughly, as the recovery can take anything from a few weeks to a year. If your vision can be corrected with less invasive methods, such as eyeglasses or special contact lenses, that is usually preferred.
If you decide to go ahead with a transplant, you’ll be placed on the waiting list at your local eye bank. It could take up to a few weeks for suitable corneal tissue to become available, and this will be subjected to screening and testing for clarity and diseases, including AIDS and hepatitis.
A corneal eye transplant is usually performed under local anesthetic as an outpatient. It generally takes up to an hour to complete, and you should be free to go home the same day. The surgeon will consider your age, health, and your preference before deciding whether to perform the operation under a local or general anesthetic.
With a local anesthetic, an injection in the skin surrounding your eye will relax the muscles to prevent blinking and eye movements. Your eye will then be numbed with eye drops.
A lid speculum will be used to ensure your eyelids remain open throughout the procedure, and the damaged part of your cornea will be removed with the use of a cutting instrument such as a laser.
The donor tissue will be cut to match your eye and will either be sutured into place or slid in using a small incision and an air bubble. A plastic shield helps protect your eye during healing.
You’ll need to wear an eye patch for a few days while the top layer of your cornea is healing, as it might feel a bit sore and light sensitive. The healing process is slow, as your cornea doesn’t receive any blood, and you may be prescribed eye drops and pain medications.
Healthcare professionals consider this procedure safe and routine.
However, as with all surgeries, there are risks.
With transplants, there is a risk that the body’s immune system will reject the donated tissue. This can sometimes be treated with medication, but sometimes another transplant is required with different tissue.
With corneal transplants, there is such a small amount of donor tissue used that the risk of rejection is very low.
Other risks include:
- Astigmatism – where the cornea doesn’t curve perfectly
- Retinal Detachment – where the retina pulls away from the blood vessels
- Cataracts – where the eye’s lens becomes cloudy
- Glaucoma – where trapped fluid causes pressure to build up in the eye
- The original eye disease returning
Most people have excellent results, with the majority of transplant patients getting at least part of their vision back. It could take up to a year before your vision has fully improved, and you may find your vision worsens before you see any improvement.
The donated tissue should generally last a lifetime, but should visit to your eye doctor regularly to ensure no complications develop.