Corneal Transplant

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Corneal Transplant FAQs


What is the cornea?
What can cause a corneal injury?
What causes corneal disease and degeneration?
What is a corneal transplant?
How are corneal transplants performed?
What happens after surgery?
What complications can occur?
Corneal Tranplant Animation

WHAT IS THE CORNEA?
The cornea is the clear front window of the eye. It transmits light to the interior of the eye allowing us to see clearly. Corneal injury, disease, or hereditary conditions can cause clouding, distortion, and scarring. Corneal clouding, much like frost on a glass windowpane, blocks the clear passage of light to the back of the eye, reducing sight sometimes even to the point of blindness. In addition, corneal injury and disease can be painful, sometimes the most intense pain we can experience.

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WHAT CAN CAUSE A CORNEAL INJURY?
Knives, pencils, and other sharp objects can cause severe injury to the cornea. Fireworks, exploding batteries, and toxic chemicals, especially alkalis, can also result in severe scarring of the cornea. In fact, protection of the cornea is the reason emergency washing of the eye is absolutely necessary when the eye is exposed to toxic chemicals. Most corneal injuries are preventable with protective glasses and proper precautions when dealing with hazardous substances.

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WHAT CAUSES CORNEAL DISEASE AND DEGENERATION?
Infections, whether bacterial, fungal, or viral are frequent causes of severe corneal damage and ulceration. Abnormal steepening of the cornea (keratoconus), degeneration occasionally following cataract surgery (corneal edema or swelling), and some aging processes can also affect the clarity and health of the cornea.

Some disorders or the cornea are inherited, and can lead to corneal clouding and loss of sight.

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WHAT IS A CORNEAL TRANSPLANT?
If the cornea becomes cloudy, the only way to restore sight is to replace or transplant the cornea. Corneal transplantation (keratoplasty) is the most successful of all tissue transplants. The success rate depends on the cause of the clouding. For example, corneal transplants for degeneration following cataract surgery and those for keratoconus both have high success rates, while corneal transplants for chemical burns have lower success rates.

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HOW ARE CORNEAL TRANSPLANTS PERFORMED?
Corneal tissue for transplant comes from an eye bank. The process begins at the death of someone who has been generous enough to be a donor. Names of patients needing corneal transplants are placed on a waiting list until tissue is available. The operation consists of a transfer of the clear central part of the cornea from the donor's eye to the patientís eye. Soon after the operation, the patient can walk about and resume activity.

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CORNEAL TRANSPLANT ANIMATION


1. White arrow shows opaque, damaged cornea.

2. Round shaped portion of damaged cornea removed.

3. A donor button of clear cornea is replaced.

4. The donor cornea is sutured into place.

 

 

 

 

WHAT HAPPENS AFTER SURGERY?
Return of best vision after corneal transplant surgery may take up to a year after the operation, depending on the rate of healing and the health of the rest of the eye. As in any kind of transplant, rejection of the donated tissue can take place. The major signs of rejection are redness of the eye or worsening of vision. If these occur, prompt return to your ophthalmologist is necessary even if it is years after the original operation.

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WHAT COMPLICATIONS CAN OCCUR??
Corneal transplants are rejected 5% to 30% of the time. The rejected cornea clouds and vision deteriorates. Most rejections, if treated promptly, can be stopped with minimal injury. Warning signs of rejection are:

Persistent discomfort
Light sensitivity
Redness
Change in vision

Any of these symptoms should be reported to Dr. Larrazabal or Dr. Ho promptly. NOTE: Flu shots can sometimes cause rejection. Please check with Dr. Larrazabal or Dr. Ho before getting a flu shot.
Other possible complications include:

Infection
Bleeding
Swelling or detachment of the retina
Glaucoma

All of these complications can be treated. A corneal transplant can be repeated, usually with good results, but the overall rejection rates for repeated transplants are higher than for the first time around.
Irregular curvature of the transplanted cornea (astigmatism) may slow the return of vision but can also be treated. Vision may continue to improve up to a year after surgery.
Even if the surgery is successful, any other eye conditions, such as macular degeneration (aging of the retina), glaucoma or diabetic damage may limit vision after surgery. Even with such problems, corneal transplantation may still be worthwhile.
A successful corneal transplant requires care and attention on the part of both patient and physician. However, no other surgery has so much to offer when the cornea is deeply scarred or swollen. The vast majority of people who undergo corneal transplants are happy with their improved vision.

Of course, corneal transplant surgery would not be possible without the hundreds of thousands of generous donors and their families who have donated corneal tissue so that others may see.

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