In corneal transplantation, the aim is to replace a diseased, scarred, or cloudy cornea with a healthy one in order to allow light to reach the retina (similar to the film of a camera) in the back of your eye. Special surgical instruments are used to remove the diseased part of the cornea and replace it with a clear donor cornea. Fine sutures secure the donor cornea in place, and antibiotic drops are given to prevent infection. The eye is dressed with sterile gauze pads and a protective shield. Following surgery, the eye needs to be protected and eye drops should be applied for several months to years to promote healing and prevent rejection (failure of the transplant). Some patients get good vision in two to three months, while others must wait about a year for complete healing.
If necessary, additional surgical procedures can be performed at the same time as the transplant. The most common combination is the removal of a cataract and the insertion of an artificial lens. Surgeons can also perform other procedures, such as a glaucoma surgery. In these situations, the corneal transplant is usually done after the other procedure has been completed. Even a successful corneal transplant does not guarantee perfect vision. Glasses or contact lenses may be needed after surgery to maximize vision.
Corneal transplantation is very common in the United States with about 36,000 transplants performed each year. Corneal transplants have restored sight to many people who would have been blinded permanently by corneal injury, infection, or inherited corneal disease or degeneration. The most important factors determining success are the underlying disease process and the quality of the tissue used during transplantation. In some cases, the body may start to reject the new cornea. If this happens, medication can be administered at the first sign of symptoms, which increases the chance of success. For this reason, it is important that patients immediately report sudden changes in their condition to their surgeon. There are four signs of rejection that can be remembered by the mnemonic RSVP: Redness, Sensitivity to light, decreased Vision, or Pain.