How long does cornea surgery take?
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. Corneal surgery can be preformed to remove the damaged cornea and replace it with a clear donor cornea.
What is a corneal transplant?
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. Due to conditions such as scarring after injury or infections, keratoconus, a hereditary corneal failure, or any other condition resulting in glare or blurred vision, corneal surgery can be preformed.
The cornea is the outermost layer of the eye and is clear. This layer is there to help protect your eye from outside debris and helps you see things clearly. Through a cornea transplant surgery, your vision can improve significantly and has a high success rate. This surgery does require a donor cornea and thus there typically is a wait until one can become available.
How does the corneal transplant work?
The cornea transplant surgery removes part of your damaged cornea tissue and is then replaced with the donor’s cornea in the same size. Tiny cuts along the outer edge by a laser or a blade are specifically done to ensure the best possible healing process. Once the whole procedure is completed, your doctor will place bandages over your eye to ensure it is protected while healing. Follow up appointments are important to ensure everything is healing correctly.
There are a few different types of corneal transplant surgery. 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.
How long does cornea surgery take?
Your surgery time will take about two hours, with time following in post anesthesia care to recover. The time the surgery takes is broken down to three steps:
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.
Surgery: 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 repair.
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.
Some redness, tearing, light sensitivity, and irritation for a few days after your surgery are to be expected after a cornea surgery. You will be given an eye shield that will protect your treated eye during sleep while it recovers. Eye drops and ointments will be prescribed to protect the eye from complications.
What about DSAEK and Pterygium surgery, how long do those take?
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.
The total time the patient will be in the surgery center is approximately 2 to 4 hours. Once the patient is taken to the operating room, the procedure is completed in 20 to 30 minutes.
Additional time may be necessary if other procedures are also planned, like cataract surgery or intraocular lens replacement. After your procedure is completed you will be taken to the recovery room where you will lie on your back for 45 to 60 minutes. This allows the air that has been placed in the anterior chamber of their eye to secure the new transplant into position.
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.
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.
Occasionally, the transplant may “detach” from the more superficial layers of the cornea and the transplant would have to be repositioned. Other times, the transplant may fail and would have to be replaced. If the DSAEK fails, either after one or multiple attempts, a traditional corneal transplant operation can still be performed. Similar to other organ transplants, anti-rejection medications are required for a number of years— however, rather than pills, eye drops are used for this purpose.
Pterygium surgery:
Pterygium surgery is a procedure performed to remove noncancerous conjunctiva growths (pterygia) from the eye. The conjunctiva make up the clear tissue covering the white part of the eye and the inside of the eyelids. Some cases of a pterygium produce little to no symptoms, however severe overgrowth of conjunctiva tissue can cover the cornea and interfere with your vision.
Pterygium surgery is a minimally invasive surgery, that generally takes no more than 30 to 45 minutes. Before your surgery date we will provide you with general guidelines to help you feel prepared. You will be required to fast or only eat a light meal beforehand. In addition, if you wear contact lenses, you will be asked to not wear them for at least 24 hours before the procedure. Because you’ll be lightly sedated, doctors will require you to arrange transportation after the surgery, as you’ll be unable to drive yourself.
Once the pterygium is removed, we will either use sutures or fibrin glue to secure the conjunctiva tissue graft in its place. Both techniques reduce the possibility of recurring pterygia. While using dissolvable sutures may be considered a benchmark practice, it can cause more discomfort post surgery, and extend the recovery time for several weeks. We will discuss whether using traditional sutures versus fibrin glue suture are appropriate for you.
At the end of surgery, your doctor will apply an eye patch or pad for comfort and to prevent infection. It’s important to not rub your eyes after the procedure to avoid dislodging the attached tissue.
We will provide you with aftercare instructions, including cleaning procedures, antibiotics, and scheduling follow-up visits.
Recovery time can take anywhere between a couple of weeks to a couple of months for your eye to completely heal, without signs of redness or discomfort. However, this may also be dependent on the type of technique used during surgery.
How successful are corneal transplants?
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.
How can Perich Eye Center help?
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 corneas. If you are interested in scheduling a consolation with us, please click here to fill out our contact form or call one of our many Central Florida locations today directly (See locations and their phone numbers below).
