What is a Cornea Transplant?

A cornea transplant is a surgical procedure in which part or all of a patient's cornea is removed and replaced with donor material from a cadaver, usually obtained through an eye bank or an organ and tissue bank. The cornea transplant is one of the most widely performed transplant surgeries in the world, and also one of the oldest, with documented successful cases dating to the early 1900s. This procedure is generally recommended when a patient has severe corneal damage, vision problems, or inflammation of the cornea which cannot be resolved.

In a basic cornea transplant, a “button” of material is removed from the patient's cornea and replaced with a corresponding button taken from a cadaver. The donor cornea is then stitched in place. It is also possible to perform partial transplants which only involve the upper layers of the cornea, or a procedure known as a deep lamellar transplant, in which one of the lower layers of the cornea is removed through a slit along the side of the cornea, leaving the upper layers of the patient's cornea intact.

This procedure is performed by an ophthalmologist, and can be done under general anesthesia or with a local anesthetic and sedation. The healing process is quite prolonged, usually taking a year or more. In the early stages of healing, the patient needs to wear eye protection to avoid physical trauma, and take steroids to resist rejection. Vision is typically very blurry at first, gradually resolving over time, and the stitches can be removed in three to 18 months, depending on how well the patient heals. Transplant rejection can occur in as many as 18% of cases.

Many people who have received a cornea transplant develop astigmatism, which needs to be corrected to allow the patient to see clearly. The patient may wear glasses to address the issue, and it is also possible to wear specially designed contacts to address the astigmatism. However, fitting contacts can be challenging after transplant, and this may not be an option for all patients, so patients should be prepared to wear glasses after a cornea transplant.

Also known as penetrating keratoplasty or corneal grafting, a cornea transplant can make a huge improvement in a patient's quality of life. Candidates for transplant will be given a thorough eye exam and educated about the potential risks and aftercare involved with a cornea transplant. If a patient is a good candidate, he or she will be put on a waiting list, and when a donor cornea becomes available, the surgery can be scheduled.