Cornea Transplant Definition
A transplant procedure involves replacing diseased corneal tissue with either full thickness or partial thickness donor corneal tissue from a recently deceased human donor. These remarkable procedures can restore or improve vision when it becomes impaired by corneal disease.
The cornea is located on the outer surface of the eye and can be described as the “window to vision”. This structure allows light to pass through the lens of the eye to the retina, and focuses light into a visible image on the retina. Because the course and prognosis of corneal transplants depend on the diagnosis and condition of the cornea, a complete pre-operative evaluation will be required prior to surgery. In addition to details of the corneal problem, our eye surgeon will make every attempt to assess the general health of the eyes since other factors such as retinal and optic nerve function affect prognosis. It may be surprising to know that according to the National Eye Institute (NEI), over 40,000 cornea transplants are performed each year in the US. Over the years the success rate for corneal transplant surgery for a wide range of corneal problems has improved.
Cornea transplants are typically performed in cases where non-surgical options have been exhausted, and when non-transplant surgical alternatives are inadequate. Corneal transplants can be performed under local or general anesthesia, depending on patient preference, patient condition, and the details of the surgical plan. After the anesthetic is given, our Maine Eye Center corneal transplant surgeon will remove the diseased portion of the cornea and will replace it with new corneal tissue. Corneal donor tissue is obtained through a national eye-banking system that processes donor tissue, including assessment of quality and suitability, and comprehensive testing for infectious disease. For conventional transplants, corneal sutures are used, and generally remain in place for many months. Routine exams are required to monitor the healing process. During this phase, use of eye drops is essential to regulate healing, and success generally depends on their regular use as prescribed. All transplant patients must understand that recovery of vision can be a lengthy process, and should not expect immediate results. Part of each postoperative visit is an assessment of individual progress, and patients should feel free to ask questions about their status at any time.
Why would you consider a corneal transplant?
- Fuchs’s Dystrophy Eye Disease
- Complications from prior eye surgery
- Keratoconus (corneal steepening)
- Scars from Infections, trauma or other causes
- Hereditary conditions
- Rejection of previous cornea transplant
Many people wonder about the risk of a cornea transplant failure. The good news is that corneal transplants are generally successful, and more so than any other organ transplant. Individual prognosis however depends on the reason for the transplant, and the individual patient’s condition. As with use of any living donor tissue, there is a small but present lifetime chance of transplant rejection. If this occurs, both medical and surgical options are available, and the prognosis for restoration of the prior level of vision is generally quite good, even when a replacement transplant becomes necessary.
DSEK – A new kind corneal transplant
A new kind of corneal transplant, known as Descemet’s Stripping Endothelial Keratoplasty (DSEK), has been introduced for treatment of corneal disease that is confined to the inner layers of the cornea, including Fuchs’ Dystrophy and some cases of cataract surgery complications. This technique employs only a very thin portion of the donor’s cornea for transplant. When appropriate, this procedure has substantial advantages over a full cornea transplant. Please feel free to visit our Maine Eye DSEK page for more information.