The cornea is the clear dome shaped structure at the front surface of the eye. The cornea focuses the light allowing clear vision. If the cornea is damaged the vision can be blurred and the eye can become red and painful. A corneal transplant (keratoplasty) is a surgical procedure to replace part of the cornea with corneal tissue from a donor (usually a deceased person). A corneal transplant can restore vision, reduce pain and improve the appearance of a damaged or diseased cornea.
Which conditions are treated with a corneal transplant?
- Fuchs dystrophy
- Diseases causing thinning of the cornea
- Corneal scarring, caused by infection or injury
- Clouding/swelling of the cornea
- Corneal ulcers and perforation, including those caused by infection
- Complications from previous eye surgery
Types of Corneal Transplant Surgery
1. Full thickness corneal transplant- also known as a penetrating keratoplasty
2. Endothelial keratoplasty- this procedure involves removing the diseased tissue from the back layers of the cornea, including the endothelium and Descemet membrane and replacing it with donor tissue. There are two main types of surgery, DSAEK-Descemet membrane automated endothelial keratoplasty(this replaces about 1/3 of the cornea) and DMEK-Descemet membrane endothelial keratoplasty(this uses a much thinner layer of donor tissue and is more technically demanding).
3. Deep anterior lamellar keratoplasty (DALK)- this involves removing diseased tissue from the front corneal layers, including the epithelium and stroma, but leaves the back endothelial layer in place.
Corneal transplant surgery is a relatively safe procedure, however like all surgery it does carry a small risk of serious complications such as
- Eye infection
- Cataract (clouding of the lens)
- Glaucoma (increased pressure within the eye)
- Problems with the stitches used to secure the donor cornea
- Rejection of the donor cornea
- Swelling of the cornea
Signs and Symptoms of Corneal Rejection
In some cases, even years after surgery, the body’s immune system can mistakenly attack the donor cornea. This is called rejection, and it may require medical treatment or another corneal transplant.
Make an appointment to see your eye doctor if you notice any signs or symptoms of rejection such as
- Loss of vision
- Sensitivity to light