Corneal Transplant

What Is It?

The cornea is the clear, round, "window" of tissue that allows light to enter the front of the eye. If the cornea becomes severely diseased or damaged, it can distort or even block the normal path of light into the eye. When this happens, light does not focus normally on the retina, the layer at the back of the eye that is responsible for sight. As a result, there can be a significant loss of vision in the affected eye.

When corneal problems seriously impair vision, a corneal transplant often is the best solution. In a corneal transplant, an eye surgeon first removes the diseased or damaged area of cornea. The removed tissue then is replaced by a section of healthy cornea that has been taken from the eye of a dead donor.

Donor corneas come from a local eye bank that has been certified by the Eye Bank Association of America. The role of the local eye bank is to locate and process donor corneas, and to distribute them to eye patients registered on a transplant waiting list. In most cases, the waiting time for a suitable cornea is fairly brief, often a matter of days. Usually, you can have the transplant done as an outpatient.

Corneal transplantation is the most common type of transplant surgery done in the United States. More than 40,000 corneas are transplanted each year in the United States, where the procedure has a very high success rate.

What It's Used For

Corneal transplantation is used to treat corneal infections, corneal dystrophies (diseases that cloud the cornea), traumatic corneal injuries and corneal scars that cannot be corrected by other therapies. Some examples include:

• Bullous keratopathy, a progressive swelling and blistering of the cornea
• Keratoconus, an eye disorder in which the middle of the cornea thins and eventually bulges outward
• Severe corneal ulcers caused by bacterial, fungal, parasitic or viral eye infections
• Severe traumatic injuries that pierce or cut the cornea
• Chemical burns of the eye
• Corneal scars
• Fuch's endothelial dystrophy, a progressive eye disease that causes swelling, cloudiness, and blistering of the cornea
• Failure or rejection of a previous corneal transplant

Preparation

If you have any uncontrolled eye problems that might threaten the success of your transplant, your doctor will address them before surgery. You also will need a basic medical evaluation to confirm that you are healthy enough to have the transplant procedure.

As part of your preparation for surgery, your doctor will ask you about any medications you are taking, including over-the-counter medications and natural or herbal remedies. Your doctor may ask you to decrease or discontinue certain drugs before surgery. This is because some medicines can increase the risk of bleeding or other surgical complications.