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Home » Eye Care Services » Your Eye Health » Eye Conditions » Corneal Transplant

Corneal Transplant

A cornea transplant, also known as keratoplasty or a corneal graft, replaces damaged tissue on the clear front surface of the eye.

When disease or injury damages the cornea, eyesight is affected. Light that enters the eye becomes scattered, resulting in blurred or distorted vision. When the cornea is extremely scarred or damaged, a corneal transplant is needed to restore functional vision.

Keratoplasty is performed routinely and is regarded as the most successful of all tissue transplants. According to the National Keratoconus Foundation, over 40,000 cornea transplants are done annually in the United States.

In recent years, an innovative type of corneal transplant has gained popularity. Known as Descemet’s Stripping Endothelial Keratoplasty (DSEK), this new procedure removes a smaller and thinner portion of the cornea. In 2009, DSEK was declared by the American Academy of Ophthalmology as superior to the conventional surgery because it may provide better vision outcomes and more eye stability. It is also associated with less risk factors. However, when the majority of the cornea is damaged, a more comprehensive removal may still be necessary to facilitate a successful transplant.

Criteria for a Corneal Transplant

A multitude of reasons indicate candidacy for a corneal transplant. Possible reasons include:

  • Eye diseases, such as keratoconus
  • Complications from laser surgery, such as LASIK
  • Extreme inflammation on the cornea
  • Scarring as a result of infections, such as eye herpes or fungal keratitis
  • Thinning of the cornea and an irregular shaped cornea
  • Hereditary factors
  • Corneal failure due to previous surgical procedures
  • Chemical burns or injuries that damaged to the cornea

Cornea Transplant Procedure

Once a patient has been recommended and approved for a corneal transplant to restore vision, the patient’s name is added to a list at an eye bank. The United States has a very advanced eye bank system, and the general wait time for a donor eye is one to two weeks. The tissue of donor corneas is checked for clarity and screened meticulously for disease before it is released for transplant.

The actual surgery is generally performed as an outpatient procedure that does not require hospitalization. General or local anesthesia may be used, depending upon the patient’s preference, age and health condition. Local anesthesia is injected into the skin surrounding the eye, which relaxes the muscles that control movement and blinking. Eye drops numb the eye itself.

Once the anesthesia has taken effect, the surgeon inspects and measures the damaged corneal area in order to decide upon the size of the transplantation. Eyelids are held open during this time. The surgeon then removes a round, button-shaped piece of the corneal tissue and replaces it with a nearly identical sized button of donor tissue. The new, healthy tissue is sutured into place. The entire procedure takes approximately one to two hours.

Following the surgery, a plastic shield must be worn over the eye in order to protect it against any inadvertent bumps or rubbing.

Rejection of the Corneal Graft

Although the vast majority of cornea transplants are successful, sometimes the new tissue is rejected. Warning signs of rejection include:

  • Extreme sensitivity to light
  • Redness
  • Pain
  • Decreased vision

These symptoms may be experienced as soon as one month after the surgery, or as delayed as five years later. Medications can be prescribed to reverse the rejection process. If the corneal graft fails completely, the transplant can be repeated and the outcome is generally positive. Yet the total rejection rates do increase with the total number of corneal transplants.

Recovery and Healing

It can take up to a year or longer to heal completely from a corneal transplant. At the beginning, vision is blurry and the transplant site is often swollen and thicker than the rest of the cornea. As vision returns, patients are able to return to normal daily tasks and most people can return to work within three to seven days after surgery. However, heavy lifting and exercise must be avoided for the first few weeks.

To help the body accept the corneal graft, steroid eye drops must be applied for several months. A pair of eyeglasses or a protective shield must also be worn for eye safety. Depending upon the health of the eye and the healing rate, stitches may be removed at any time from three months to more than a year later. Astigmatism often occurs as a result of an irregular corneal surface, and adjustments may be made to the sutures around the new cornea in an effort to reduce this problem.

Vision after a Cornea Transplant

Vision improvement after a cornea transplant is a process that can last up to one year later. Eyeglasses or contact lenses must be worn immediately after the surgery, since the curvature of the corneal transplant will not precisely match the natural corneal curve.

When healing is complete and stitches are removed, laser surgery may be indicated to correct vision. LASIK or PRK are both procedures that can help decrease dependence on eyeglasses or contacts. An irregular corneal surface may point to the need to wear rigid gas permeable (GP) contact lenses for vision correction.

Dear Valued Patient:

We plan to re-open on May 20, 2020 to a limited schedule by appointment only—please set appointment online or call or email first.

We look forward to see you again soon!  We place the highest priority on the health and safety of our patients and our eye care staff.  Please read below:

Please read the following carefully to prepare for your visit to our office. We are implementing many new and more stringent procedures to ensure the health and safety of our patients and eye care personnel based on guidelines from the Alameda County Health Department and the CDC to help prevent the spread of COVID-19. During this time we are requiring the following for every patient and in-office encounter:

+We are starting with a limited schedule of appointments for better social distancing and for the safety of our patients (thank you in advance for your patience and understanding).

+All visits are by appointment only, there are no walk-in visits available

+All patients are required to wear their own personal mask before entering the office

+All patients are required to check in over the phone before their appointment

+Insurance coverage verifications must be taken care of before entering office for appointment

+Patient will wait outside in car until notified by text or email when they can come in for their appointment, upon entering, patient’s temperature will be taken and their hands sanitized with alcohol cleaner

+There will be no waiting area in the office, patient will be seen right away-please be on time

+Family or caregivers will need to wait outside in the car, as we will only allow patient to enter office.  Verbal consent for minors is acceptable. Updates will be given family or caregiver over the phone as needed.

+All glasses, contact lens orders will be by curb side pick up only—please call or email and we can help you set up a time to pick up your eye wear safely, maintaining social distancing

Our doctors and staff will increase our cleaning and sanitizing protocols:

+We have the latest HEPA air filters with UVC light disinfection to destroy bacteria and viruses

+Wearing protective face shields and surgical masks and medical grade disposable gloves

+All exam equipment and every surface is sanitized fully with hospital grade sanitizer after each patient encounter

+We have a new safe system of disinfection for all frames which have been touched or tried

+We screen all patients by phone to assure they have been healthy prior to their appointment

+All staff and doctors have passed additional training in more stringent sanitizing protocol

Thank you for your patience and compliance to these new and required guidelines. Our goal is to take care of your eye care needs while keeping you and your family healthy. We also want to help our community overcome this pandemic.

We will get through this together.

Please let us know if you have any questions or need more immediate assistance. 

You can set up a future appointment online at EyeCareDrLee.com or send an email to EyeCareDrLee@gmail.com or DrLeongOK@gmail.com  or call 510-668-0877

Please stay safe and stay healthy.

x

Stay up to date on our COVID-19 pandamic protocols Read Our Blog Post…

Our office continues to monitor the local health announcements on a daily basis. Optometry is an essential service and we will open to new health guidelines to help our patients while keeping everyone healthy. Please read our blog updates for our open date and new safety guidelines. Let us know if you have any questions or immediate eye care needs. Need contact lenses? Let us know, as we can send orders to you with free shipping.
We are responding faster to direct email:

eyecareDrLee@gmail.com

drLeongOK@gmail.com (for ortho-k)

Thank you, stay safe and stay healthy.

COVID-19 guidelines from CDC: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention-H.pdf