During the corneal transplant procedure, the diseased or scarred cornea is replaced with a healthy donor tissue. There are two main types of corneal transplant: full thickness corneal transplant (also known as a penetrating keratoplasty, or PK) and partial thickness corneal transplant (endothelial keratoplasty, or EK).
At Atlantic Laser Center, we perform corneal transplants for a wide array of conditions. Common corneal diseases that can be treated through a corneal transplant include:
- Corneal scarring. Corneal scarring can be caused by injury or disease such as ocular herpes, fungal keratitis, and trichiasis.
- Corneal dystrophy. Most cases of corneal dystrophy are irreversible and can cause blindness.
- Advanced keratoconus. Advanced keratoconus is usually not treatable except through transplant.
- Corneal edema. Corneal edema is characterized by the swelling of the cornea, often blurring vision.
Once it is decided your eye doctor that a corneal transplant is the best treatment for you, your name will be placed on a list at a national eye bank and surgery will be scheduled at Atlantic Surgery Center. When tissue becomes available, it is screened for its clarity and presence of any diseases such as hepatitis or AIDS. Only corneas that meet these strict guidelines will be cleared for use in corneal transplant surgery.
During your corneal transplant procedure, Dr. Goldberg will first administer local anesthesia. After the anesthesia has taken effect, your Atlantic Laser Center surgeon will place a device called a lid speculum on your eyes to keep your eyelids open during the procedure.
During traditional corneal transplant surgery, or penetrating keratoplasty, a full thickness section of corneal tissue is taken from the eye using either a surgical cutting instrument called a trephine or a femtosecond laser. A matching portion of donor corneal tissue is then used to replace the diseased section of corneal tissue. The tissue is positioned and sutured into place. The sutures typically stay in place for a year, sometimes more. A plastic shield is placed over your eye to protect it during the healing process.
During endothelial keratoplasty, a newer version of corneal transplant, your surgeon will begin by making a tiny incision in the cornea. Through this incision, your surgeon places a thin disc of donor tissue containing a healthy endothelial cell layer on the back surface of the eye. An air bubble is used to position the new endothelial layer into place. Typically no sutures are required. Endothelial keratoplasty requires less recovery time, less operating time, and has a reduced risk of astigmatism after surgery when compared to traditional corneal transplant.
Recovery time after a corneal transplant can take up to a year. Your vision may be blurry for the first few months as your eye gets used to its new cornea. As vision improves, you will gradually be able to return to everyday activities. For the first several weeks, we recommend staying away from heavy lifting and exercise. Most people are able to return to work a week after surgery, depending on the job.
Transplants of any kind are generally tricky. The risk of rejection of the corneal graft is about 5-30%. Corneal transplants are performed routinely and have the best success rate among other types of tissue transplants. Recognizing the signs of corneal graft rejection early on makes it easier for doctors to reverse it later.
The best way to remember these symptoms is the acronym “RSVP”, which stands for:
• Sensitivity to Light (Extreme)
• Decreased Vision
For most people, having improved or restored vision is worth the risk. Other risks and complications include eye infection and suture-related complications.
If you would like to learn more about corneal transplant, or believe you may be in need of a corneal transplant, be sure to contact Atlantic Laser Center today!