The Complete Guide to Cornea Transplant Surgery

Introduction

Keratoplasty, another name for cornea transplant surgery, is a medical treatment that involves replacing a diseased or damaged cornea with a healthy one from a donor. Clear vision is made possible by the cornea, the transparent, dome-shaped front surface of the eye. Significant vision issues, including blindness, can result from corneal injury or clouding.

Everything you need to know about corneal transplant surgery is covered in this blog, including the procedure’s risks, recuperation, aftercare, causes of corneal deterioration, and its purpose.

Why Is the Cornea Important and What Is It?

The outermost layer of the eye is called the cornea. It serves to refract or bend light to enable clear vision by covering the front of the eye like a transparent window. A healthy cornea is necessary for good vision. Any damage, infection, or illness that affects this layer has the potential to distort or block light, which can cause pain, distorted vision, or even blindness.

Why Would Someone Need a Cornea Transplant?

When the cornea is so severely injured that it cannot be repaired with medicine or simple surgery, a corneal transplant is required. Among the primary causes are:

1. Scarring of the cornea :- The cornea may have scars from injuries, diseases (such as herpes simplex), or prior procedures that impair vision.

2. Keratoconus :- The cornea thins and swells into a cone shape in this progressive disorder, which significantly distorts vision.

3. Ulcers on the cornea :- If left untreated, infections can cause corneal ulcers, which can result in irreversible damage that may require replacement.

4. Dystrophy of Fuchs :- This is a hereditary disorder in which the endothelium, the cornea’s inner layer, gradually deteriorates, causing swelling and cloudiness.

5. Failure of Graft
A second treatment may be required if a prior corneal transplant fails because of infection or rejection.

6. Burns caused by chemicals or heat :- Extreme heat or exposure to dangerous substances can cause irreversible damage to the ocular tissue.

Types of Surgery for Cornea Transplantation

Depending on how much of the cornea is restored, there are various types:

1. Keratoplasty with penetration (PK) :- The cornea’s whole thickness is restored. When every layer of the cornea is destroyed, this is optimal.

2. Deep Anterior Lamellar Keratoplasty, or DALK :- The endothelium is preserved and just the cornea’s anterior layers are replaced. In non-endothelial conditions like keratoconus, it is recommended.

3. DMEK/DSAEK :- Only the cornea’s innermost layer is replaced in these types of endothelial keratoplasty. For those who have Fuchs’ dystrophy, it is perfect.

The Operative Process

A corneal transplant typically takes one to two hours to complete as an outpatient procedure. This is how it usually operates:

1. Anesthetic :- Sedation combined with local anesthetic is frequently utilized. General anesthesia could be required in some situations.

2. Damaged Cornea Removal :- A surgical tool is used to remove a circular portion of the damaged cornea.

3. Donor Cornea Placement :- A matched donor cornea that has been examined for illnesses and infections is sewn into position.

4. Stitching :- The replacement cornea is secured with extremely thin sutures or stitches. An air bubble may be utilized in place of stitches during endothelial procedures.

5. Post-Surgery Monitoring :- Prior to being released, the patient is observed for a few hours.

The dangers and complications of surgery for corneal transplantation

There are dangers associated with corneal transplantation, just like with other medical surgery. Despite being typically safe and effective, the following are some possible side effects:

1. Refusal :- The immune system may attempt to reject the replacement cornea because it perceives it as alien. Redness, light sensitivity, discomfort, and blurred vision are early symptoms.

2. Contamination :- With the right medication and good hygiene, the risk of eye infections following surgery can be reduced.

3. Glaucoma :- Increased intraocular pressure following surgery may result in glaucoma.

4. Astigmatism :- Irregular curvature due to suturing may result in blurred vision, which may require glasses or further corrective surgery.

5. Recurrence of Disease :- In rare cases, the disease that damaged the original cornea can affect the transplanted one.

Recovery After Cornea Transplant

Recovery can take several weeks to months, depending on the type of transplant and the individual’s healing rate. Here’s a step-by-step explanation of what to expect:

1. First Few Days :- 

• Vision may be blurry
• Use of prescribed antibiotic and steroid eye drops
• Avoid touching or rubbing the eye

2. First Few Weeks :-

• Attend regular follow-ups
• Avoid lifting heavy objects
• Use sunglasses to protect from bright light

3. Long-Term :-

• Full vision recovery may take up to a year
• Stitches may be removed after 3–12 months
• Glasses or contact lenses may be needed for best vision correction

Important Aftercare and Precautions

To ensure a successful outcome, patients should strictly follow their surgeon’s advice:

1. Medication Compliance :- Take all prescribed eye drops as directed to prevent infection and control inflammation.

2. Protective Eyewear :- Use eye shields or glasses to protect the eye from accidental injury or dust.

3. Hygiene :- Wash hands before touching the eye or applying drops. Avoid dusty or dirty environments.

4. Avoid Strain :- Do not bend over excessively, lift weights, or perform strenuous activities during recovery.

5. Regular Eye Checkups :- These help detect any signs of rejection or infection early, ensuring timely intervention.

Life After Cornea Transplant Surgery

Many patients experience a significant improvement in vision and quality of life after a cornea transplant. However, vision correction with glasses or contact lenses may still be necessary. With proper care and regular follow-up, most corneal grafts can last for 10–20 years or longer.

In some cases, especially where rejection occurs or the condition recurs, a second transplant may be needed.

Conclusion

Cornea Transplant Surgery is a life-changing procedure for those suffering from severe corneal disease or injury. It restores sight, improves independence, and enhances the overall quality of life. While the surgery is generally safe, understanding the risks and committing to long-term care is vital for the best results.

If you or someone you know is dealing with blurred vision, eye pain, or corneal disease, consult an ophthalmologist to see if a cornea transplant is the right option. With medical advances and expert care, restoring clear vision is now more achievable than ever.