Corneal transplant (also called corneal grafting or penetrating keratoplasty) is the most common and most successful of all transplant operations being done today. Over 44,000 are performed each year in the United States alone, with over 90% resulting in significantly improved vision.
A normal cornea is crystal clear and its surface is smooth. If anything interferes with that clarity or smoothness, light passing through the cornea will be distorted, causing a hazy image and blurred eyesight.
Many kinds of damage to the cornea can cause it to become swollen, scarred, cloudy (even opaque), or develop irregularities in the surface. Such damage can result from direct corneal trauma, such as being hit in the eye with a sharp object, or infection from bacteria, a virus, a fungus, or other organism.
A transplant operation requires a healthy cornea from a donor who is recently deceased. The source of the donor tissue is usually a local or national eye bank.
Descemet’s Stripping Endothelial Keratoplasty (DSAEK)
In DSAEK, the surgeon uses special instruments to enter the eye through a very small incision in the front clear part of the eye (cornea). The back portion of the cornea (Descemet’s membrane) is then painlessly stripped away and replaced by a similar piece of healthy graft tissue from a recently deceased donor.
DSAEK has several advantages over conventional transplant surgery.
- No stitches are placed in the cornea. This has resulted in significantly less astigmatism following surgery and faster visual recovery.
- Usually fewer follow-up visits are required because there are no corneal stitches to be removed. Corneal transplant rejection happens less often with DSAEK than conventional transplants.
Like conventional transplantation, DSAEK surgery is covered by most major insurance carriers, including Medicare. DSAEK is not appropriate for all patients with corneal disease.
Read more about DSAEK -->>
Penetrating Keratoplasty (PKP) Conventional Corneal Transplant Surgery
In PKP, the surgeon removes the window of cloudy tissue from the patient’s cornea and replaces it with healthy donated tissue from a recently deceased donor. This new tissue is held in place with many tiny stitches. To allow healing, these stitches must remain in place for at least six months. Then they are usually removed slowly over several office visits. During this time, vision is usually very poor, and the stitches may cause discomfort. Even after all stitches are removed, vision may not return to normal because of warping or ‘irregular astigmatism’ that remains in the corneal graft.
The PKP procedure takes about an hour and may be done under local or general anesthesia. There is little or no pain. Only the central part of your cornea is removed. It is replaced with a clear corneal "button," which is sutured into position with very fine stitches. To assure precise placement of the graft, an operating microscope is used, which greatly improves the surgeon's view.
To ensure proper healing, the sutures stay in place for several months to a year or more. Sometimes they are left in place permanently.
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Related Information About Corneal Transplantation:
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Commonly Asked Questions:
How soon after surgery will I see well?
Full visual recovery takes up to a year, but most patients with
successful corneal transplants enjoy good vision for many years.
Will a cornea transplant hurt?
The operation takes about an hour and may be done under local or general
anesthesia. There is little or no pain.
Will my insurance cover corneal transplantation?
Most health insurance plans will cover at least a part of the cost of
a cornea transplant; the amount varies depending on the health plan.