How serious is a cornea transplant?
When you hear the word transplant, it’s easy to quickly feel like something is very serious and dangerous or scary. Thankfully, these days a cornea transplant surgery is generally safe with a high success rate. As with any surgery there are some people who have a harder time than others. This part of the eye is can heal very well especially when care for correctly post surgery.
What is a cornea transplant surgery?
A corneal transplant (keratoplasty) is a procedure in which some or all of a cornea in need of replacement is removed and replaced with donor tissue. The surgery may be done with traditional surgical technologies or with the aid of a surgical laser. The more damaged your cornea is, the more that will need to be replaced.
There are three main types of cornea transplants. Endothelial keratoplasty replaces only the inner layer of your corneal tissue with donor tissue. A partial thickness corneal transplant replaces only the middle and outer layers. A penetrating keratoplasty (PK) replaces the full thickness of the corneal tissue.
A corneal transplant may be necessary if you sustain a serious injury such as a deep scratch or burn. Clouding or repeated scarring of the corneal tissues over time may eventually obscure vision until you need surgery. Extremely thin corneal tissue caused by keratoconus may also require transplantation.
What is the process for a cornea transplant surgery?
Here at Perich Eye Centers, we can advise you when it’s time to consider a corneal transplant and counsel you on the procedure and after care. We can also co-manage your recovery through regular eye and vision exams. We are proud to have many years of expert experience caring for patients with cornea surgery needs.
Once determined that a cornea surgery is needed and then scheduled, here is what happens the day of:
1. Arrival
After you arrive at the outpatient surgery center, your doctor will numb your eye with drops or an injection near the eye. Your doctor may also give you a medication to relax.
2. Surgery
Your surgery time will take about two hours, with time following in post anesthesia care to recover. Your surgeon will make tiny cuts with a laser or a blade near the edge of your cornea, which is the clear covering on the front of your eye. This will enable your surgeon to reach your cornea and begin the repair.
3. Healing
In most cases, you will not need stitches to close the incisions. The so-called self-sealing incisions will close on their own in time. Your surgeon will place a shield over your eye to protect it during the healing process and while you sleep. Some redness, tearing, light sensitivity, and irritation for a few days after your surgery are to be expected. Eye drops and ointments will be prescribed to protect the eye from complications.
Due to the avascular nature of the cornea, most corneal transplants are highly successful and last for many years. Some people may experience tissue rejection, in which case another transplant may be necessary.
Where will my new cornea come from?
Regional facilities maintain tissue banks that include corneal tissue from individuals who have donated their corneas to medicine. The donor tissues are carefully inspected before surgery to make sure they are safe to use and appropriate for your eyes.
When will I see improvement in my vision?
Visual recovery varies depending on the severity of your corneal cloudiness prior to surgery. Recovery following conventional corneal transplant surgery (PKP) usually takes six to twelve months.
For patients who can have DSAEK surgery, most patients notice improvement in their vision during the first two weeks after surgery, with continued improvement during the next four to six weeks. Some DSAEK patients may not notice visual improvement as quickly as they would like, because they have other ocular conditions such as a cataract or retinal problems that must be addressed.
Your vision will be quite blurry for the first few weeks after surgery as the new cornea is healing. To follow up, repeated visits will be necessary to monitor the progress of the transplant. The total visual recovery time for a DSAEK surgery is typically between two to six months.
What is DSAEK surgery?
DSAEK, which stands for decimates stripping automated endothelial keratoplasty, is a partial-thickness corneal transplant that replaces only the innermost layer of the cornea. DSAEK is a relatively new surgical technique that affords significant improvements over traditional corneal transplants for certain indications. The surgery itself takes less time, involves a smaller surgical incision, requires minimal stitches, has a shorter healing time, and a faster visual recovery.
DSAEK surgery is performed as an outpatient procedure. Although you will not be asleep during the procedure, you will be given sedation and a local anesthetic to keep you comfortable the entire time. One of our surgeons will make a small incision comparable to that made during cataract surgery. An instrument is then used to remove the diseased inner layer of the cornea. The healthy inner layer of an organ donor cornea is then inserted into the eye and maintained in place with the use of an air bubble that is left in the eye.
During the surgery, you may feel pressure around the eye, but not pain. After the procedure, a patch will be placed over the eye and you will return home where you are instructed to rest for the remainder of the day, lying flat on your back to keep the air against the corneal transplant.
What is the risk my body will reject the DSAEK?
Although the rate of rejection with DSAEK does not appear to be any higher than rejection rates with PKP, endothelial rejection is still something to look out for. The signs and symptoms of such rejection episodes are the same as they are for PKP patients.
As a rule of thumb, if you experience redness, photophobia, and blurred vision we want you to assume that you are having a rejection episode, and for you to call our office so that you can be evaluated immediately. Most rejection episodes are successfully terminated by using steroid eye drops. The sooner a rejection is treated, the better chance for transplant survival.
We would love to help you feel more comfortable and confident on your conrea transplant journey. Please feel free to reach out to one of our many Central Florida locations that is closest to you to schedule a consultation.
