At UMC, our fellowship-trained corneal specialists offer state-of-the-art technology and surgical techniques to evaluate and treat a variety of corneal and external eye diseases.
For further information, please contact UMC Ophthalmology at (601) 815-3248 (Dr. Huang).
FREQUENTLY ASKED QUESTIONS ABOUT CORNEAL TRANSPLANTS
What is the Cornea?
Am I a Candidate for a Corneal Transplant?
How is a Corneal Transplant performed?
What happens once my Doctor and
I agree I should have a corneal transplant?
What complications can occur with
a cornea transplant?
The cornea is the clear front of the eye that covers the colored iris and
the round pupil. Light is focused while passing through the cornea so that
we can see. To stay clear, the cornea must be healthy.
But something may have happened to your cornea. It is hazy or damaged because
of disease or injury. If the cornea is damaged it may become swollen or scarred.
In any case, its smoothness and clarity may be lost. The scars, swelling or
resulting irregular shape cause the cornea to scatter or distort light, resulting
in glare or blurred vision. Like a foggy window, light no longer passes through
it well, so a blurred image forms in your eye.
Am I a Candidate for a Corneal Transplant?
A corneal transplant is typically needed when:
Vision cannot be corrected satisfactorily using other medical approaches
Painful swelling cannot be relieved by medications or special contact lenses
Corneal failure occurs after other eye surgery, such as cataract surgery
Severe Keratoconus, a steep curving of the cornea, develops
Hereditary corneal failure, such as Fuchs’ dystrophy, exists
Scarring after infections, especially after herpes, occurs
Rejection occurs after first corneal transplant
Scarring arises after injury
How is a Corneal Transplant performed?
What happens once my Doctor and I agree I should have a corneal transplant?
Before Surgery
Once you become a corneal transplant candidate, your name is put on a list
at the local eye bank for donated cornea tissue (much like the case of an
organ recipient). Typically, the wait is short due to the tremendous efforts
of local and national eye bank organization awareness about cornea donations
in this country.
Before a cornea is released for transplant, the eye bank tests the donor for
the viruses that cause hepatitis and AIDS. The cornea is carefully checked
for clarity. You may be required to have a physical examination and other special
tests prior to surgery. If you usually take medications, ask if you should
continue them up to the day of surgery. In certain situations, it is best to
match the blood types of donor and recipient. If this is your situation, you
will be asked to have a blood sample drawn when preparing for transplant surgery.
The day of surgery
Surgery is often done on an outpatient basis. You may be asked to skip breakfast,
depending on the time of your surgery. Once you arrive for surgery, you will
be given eye drops and medications to help you relax.
The operation is virtually painless. Anesthesia is either local or general,
depending on your age, medical condition and eye disease. You will not see
the surgery while it is happening, and will not have to worry about keeping
your eye open or closed.
The surgery
The eyelid is gently opened. Looking through a surgical microscope, your eye
is measured to tailor the corneal issue to be transplanted. The diseased
or injured cornea is carefully removed from the eye. Any necessary additional
work within the eye, such as removal of a cataract, can often be completed
at the same time. Then the clear donor cornea tissue is sewn into place.
When the operation is over, a shield is usually placed over your eye.
After surgery
If you are an outpatient, you may go home after a short stay in the recovery
area. You should plan to have someone else drive you home. An examination
at the doctor’s office will be scheduled for the following day.
Your post-operative instructions will ask you to:
Use the eye drops as prescribed
Be careful not to rub or press on your eye
Use over-the-counter pain medicine, if necessary
Continue normal daily activities except exercise
Refrain from driving until you have received doctor’s approval
Ask your doctor when you can begin driving
Wear eyeglasses or an eye shield
When your stitches will be removed will depend upon the health of the eye and
rate of healing. Usually, it will be several months, at least, before stitches
are removed.
What complications can occur with a cornea transplant?
Because corneal transplants use donor tissue, the donor tissue is rejected
5% to 30% of the time. The rejected cornea clouds and vision deteriorates.
Most rejections, if treated promptly, can be stopped with minimal injury.
Warning signs of rejection are:
Persistent discomfort
Light sensitivity
Redness
Change in vision
Any of these symptoms should be reported immediately.
Other possible complications include;
Infection
Bleeding
Swelling or detachment of the retina
Glaucoma
All of these complications can be detected and treated by an experienced cornea
surgeon. Therefore, it is important that your post-operative care be supervised
carefully by your surgeon.
A corneal transplant can be repeated, usually with good results, but the overall rejection rates for repeated transplants are higher than for the first time around. Irregular curvature of the transplanted cornea (astigmatism) may slow the return of vision but can also be treated. Vision may continue to improve up to a year after surgery. Even if the surgery is successful, any other eye conditions, such as macular degeneration (aging of the retina), glaucoma or diabetic damage may limit vision after surgery. Even with such problems, corneal transplantation is still usually worthwhile.
A successful corneal transplant requires care and attention on the part of both patient and doctor. However, no other surgery has so much to offer in terms of vision improvement when the cornea is deeply scarred or swollen. The vast majority of people who undergo corneal transplants are extremely pleased with their improved vision. Of course, corneal transplant surgery would not be possible without the hundreds of thousands of generous donors and their families who have donated corneal tissue so that others may see.