Corneal Transplants
The cornea is the clear structure at the front of the eye that allows light to enter and focuses this light onto the retina. A healthy cornea is essential for good vision and any condition that affects the clarity of the cornea can affect your vision. Examples of these include:
Cornea infections and a cornea ulcer can cause a cornea scar
Keratoconus can change the shape of the cornea
While there are various medical and surgical treatments available to treat these conditions, sometimes a cornea transplant is necessary due to the type or severity of the corneal disorder.
What is a corneal transplant?
A corneal transplant is a surgical procedure that aims to restore vision by replacing either all or part of the affected cornea with healthy donor tissue.
If the full thickness of the cornea is involved in the condition, the entire cornea is replaced with a donor cornea (or graft) in a procedure known as a penetrating keratoplasty (or PK). This may be the case with corneal scars from trauma or corneal dystrophies that are genetic conditions affecting the cornea.
The cornea can be divided into three layers: the outer epithelial layer, the middle stromal layer and the inner endothelial layer. Some corneal disorders affect only one layer (or lamella). In these cases, latest advances in corneal transplant surgery aim to replace only the affected layer while preserving as much healthy cornea as possible. These techniques improve the success rates, visual outcome and recovery time.
For example, superficial corneal scars, keratoconus and some corneal dystrophies that only affect the middle stromal layer can be treated with a technique known as a deep anterior lamellar keratoplasty (or DALK). This technique replaces the epithelial and stromal layers while preserving the inner endothelial layer.
In Fuchs endothelial dystrophy, only the inner endothelial layer is involved so an endothelial keratoplasty (DMEK) can be performed, exchanging the diseased tissue with a healthy graft layer from the donor.
Mr. Darcy offers the entire range of transplant procedures and will guide you through this process.
What is involved in Corneal Transplant Surgery?
Corneal transplant surgery is usually performed with one overnight stay, under local or general anaesthesia dependent on the type of procedure and your preference. It is often combined with another procedure such as cataract surgery.
How long is the recovery after Corneal Transplant Surgery?
The recovery period depends on the type of corneal transplant procedure performed.
We will guide you through the process but in general it is advisable to take 2-4 weeks to recover after your surgery. You should avoid heavy lifting or swimming for one month. We normally prescribe antibiotic drops for a short period to prevent infection and anti-inflammatory drops for a longer period to assist with healing and reduce the risk of graft rejection. In graft rejection, the body recognises the graft as foreign material and mounts a response to fight it. If left untreated, the graft can fail.