In corneal transplant surgery, or Penetrating Keratoplasty (PKP), the damaged central cornea is removed and a clear donor cornea is sewn into place. Corneal specialists perform more than 40,000 corneal transplants each year in the United States. Of all transplant surgeries done today – including heart, lung and kidney – corneal transplants are the most common and successful.
A Corneal Transplant may be needed if such conditions exist:
- Corneal failure after other eye surgery, such as cataract surgery
- Keratoconus (a steep curving of the cornea)
- Hereditary corneal failure, such as Fuch’s corneal dystrophy
- Scarring after infections, especially after certain viruses
- Rejection after first corneal transplant
- Scarring after injury
Once it is decided a corneal transplant is warranted, the patient’s name is put on a list at the local eye bank. Usually there is no wait. Before any cornea is released for transplant, the eye bank tests the human donor for diseases, and the viruses that might cause hepatitis and AIDS. The cornea is carefully checked for clarity and is kept sterile.
The Day of Surgery
Surgery is often done on an outpatient basis. On arrival for surgery, the eye will be given drops and the patient given medications to help them relax. Anesthesia is usually general, depending on the age, medical condition and eye disease.
The eyelids are gently opened. Looking through a surgical microscope, the surgeon measures the eye for the size for the corneal transplant. The central part of the diseased cornea is carefully removed from the eye. Then the clear donor cornea is sewn into place, making the diseased cornea again clear in the center. When the operation is completed, a shield is placed to protect the eye.
Most patients may go home after a short stay in the recovery area, and should plan to have someone else drive them home. An examination at the doctor’s office will be scheduled for the following day.
Patients will need to:
- Use the eye drops as prescribed
- Be careful not to rub or press on the surgery eye
- Use mild pain medicine, if necessary
- Continue light normal daily activities except exercise
- Ask the doctor when they can begin driving
- Wear eyeglasses or an eye shield as advised post operatively
Usually it takes at least 3-6 months for full healing and before stitches are removed from the transplanted cornea. The decision to remove the stitches is made jointly by the patient’s primary eye doctor and eye surgeon. There is typically some short term swelling of the cornea that limits vision, and any residual astigmatism is managed as the eye heals. Recovery is much slower than in cases of cataract surgery.