Corneal Transplant
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Corneal Transplant FAQs
What
is the cornea?
What can cause a corneal injury?
What causes corneal disease and degeneration?
What is a corneal transplant?
How are corneal transplants performed?
What happens after surgery?
What complications can occur?
Corneal Tranplant Animation
WHAT
IS THE CORNEA?
The cornea is the clear front window
of the eye. It transmits light to the interior of the eye
allowing us to see clearly. Corneal injury, disease, or
hereditary conditions can cause clouding, distortion, and
scarring. Corneal clouding, much like frost on a glass windowpane,
blocks the clear passage of light to the back of the eye,
reducing sight sometimes even to the point of blindness.
In addition, corneal injury and disease can be painful,
sometimes the most intense pain we can experience.
WHAT
CAN CAUSE A CORNEAL INJURY?
Knives, pencils, and other sharp objects can cause severe
injury to the cornea. Fireworks, exploding batteries, and
toxic chemicals, especially alkalis, can also result in
severe scarring of the cornea. In fact, protection of the
cornea is the reason emergency washing of the eye is absolutely
necessary when the eye is exposed to toxic chemicals. Most
corneal injuries are preventable with protective glasses
and proper precautions when dealing with hazardous substances.
WHAT
CAUSES CORNEAL DISEASE AND DEGENERATION?
Infections, whether bacterial,
fungal, or viral are frequent causes of severe corneal damage
and ulceration. Abnormal steepening of the cornea (keratoconus),
degeneration occasionally following cataract surgery (corneal
edema or swelling), and some aging processes can also affect
the clarity and health of the cornea.
Some disorders or the cornea are inherited, and can lead to corneal clouding and loss of sight.
WHAT
IS A CORNEAL TRANSPLANT?
If the cornea becomes cloudy, the only way to restore sight
is to replace or transplant the cornea. Corneal transplantation
(keratoplasty) is the most successful of all tissue transplants.
The success rate depends on the cause of the clouding. For
example, corneal transplants for degeneration following
cataract surgery and those for keratoconus both have high
success rates, while corneal transplants for chemical burns
have lower success rates.
HOW
ARE CORNEAL TRANSPLANTS PERFORMED?
Corneal tissue for transplant comes from an eye bank. The
process begins at the death of someone who has been generous
enough to be a donor. Names of patients needing corneal
transplants are placed on a waiting list until tissue is
available. The operation consists of a transfer of the clear
central part of the cornea from the donor's eye to the patientís
eye. Soon after the operation, the patient can walk about
and resume activity.
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WHAT HAPPENS AFTER SURGERY?
Return of best vision after corneal transplant surgery may
take up to a year after the operation, depending on the
rate of healing and the health of the rest of the eye. As
in any kind of transplant, rejection of the donated tissue
can take place. The major signs of rejection are redness
of the eye or worsening of vision. If these occur, prompt
return to your ophthalmologist is necessary even if it is
years after the original operation.
WHAT
COMPLICATIONS CAN OCCUR??
Corneal transplants are 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 to Dr. Larrazabal or
Dr. Ho promptly. NOTE: Flu shots can sometimes cause
rejection. Please check with Dr. Larrazabal or Dr. Ho
before getting a flu shot.
Other possible complications include:
Infection
Bleeding
Swelling or detachment of the retina
Glaucoma
All
of these complications can be treated. 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
may still be worthwhile.
A successful corneal transplant requires care and attention
on the part of both patient and physician. However, no other
surgery has so much to offer when the cornea is deeply scarred
or swollen. The vast majority of people who undergo corneal
transplants are happy 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.