What is Corneal Transplantation?

Corneal transplantation or keratoplasty is also known as corneal grafting. It is an operation designed to correct blindness resulting from corneal disease. It involves removal of the damaged or diseased cornea which is replaced by donated healthy corneal tissue (the graft) either in its entirety (penetrating keratoplasty) or in part (lamellar keratoplasty). The graft is taken from a recently deceased individual with no known diseases or other factors that may affect the viability of the donated corneal tissue or the health of the recipient.

Only the corneal tissue (and not the whole eye) donated by one person is transplanted into the diseased eye of another person who has been blinded by a corneal scar or disease.

Are you a cornea transplant candidate?

Patients with conditions leading to corneal blindness benefit from corneal transplantation. Some of these indications are…

1. Corneal scarring from past infections, injuries or surgeries.

2. Keratoconus and other conditions with the thin and distorted cornea.

3. Swelling in cornea due to hereditary weakness of corneal cells or due to surgery

4. Complications from LASIK, chemical injuries.

Will my eye color change after corneal transplantation?

Some mistakenly believe that a blue-eyed person’s eyes cannot be used for transplantation in a brown-eyed person. The only tissue used in the transplant is the cornea, which has nothing to do with the colored part of the eye.

Is the whole eye replaced during transplantation?

Many people are under the false impression that one good eyeball is transplanted for another eyeball which is diseased. Since the eye is connected to the brain by the optic nerve, which is a part of the central nervous system, the eye is not and cannot be transplanted.

How is a cornea transplanted?

There is a perpetual shortage of donor corneas in our country due to poor awareness about eye donation. That’s why you need to first register for the corneal transplant. The waiting period depends on the voluntary donation of eyes from the community.

A corneal transplantation, like a cataract operation, is usually performed under local anesthesia. General anesthesia is used for children and apprehensive or nervous patients. The operation is completely painless and takes about one hour to perform.

The diseased, cloudy, opaque cornea is removed from the recipient’s (living patient’s) eye using a special blade and replaced by a new clear cornea (graft) from the donor’s (deceased person’s) eye. The new cornea is then sutured or stitched into place. Usually, 16 sutures are used to hold the graft or transplanted cornea in its position.
Recently, a new technology called Femtosecond Laser (IntraLase^TM)
is available to make precise laser aided cuts in the donor and host cornea. Intralase-aided cuts improve wound healing and require less number of sutures leading to faster recovery.

Vision after corneal transplantation:

If the operation is successful and the graft is accepted by the recipient’s eye, it remains clear and the vision starts to improve with time (provided the lens and the retina behind the cloudy cornea are normal).

Healing after the corneal transplant is a slow process and takes up to 1 year before all sutures can be removed. The vision fluctuates over the first 6 months and glasses are prescribed after healing is complete.

Additional surgery like LASIK or PRK  can be done if a patient wants to get rid of glasses.

Postoperative care:

The patient is usually hospitalized for one day but requires rest for the next one month although returning to light work is not a problem. However frequent follow-ups are required over the following six months to one year.

Meticulous post-op care of the operated eye is required. A patient should maintain good hygiene, avoid vigorous physical activity and must not rub the operated eye.

THE OCCURRENCE OF PAIN, REDNESS, WATERING, LIGHT-SENSITIVITY AND DIMINISHED VISION, ANYTIME (EVEN MONTHS OR YEARS) AFTER CORNEAL TRANSPLANTATION SURGERY, REQUIRES IMMEDIATE ATTENTION OF YOUR OPHTHALMOLOGIST.