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by de la Rocha K
(Keratoplasty; Penetrating Keratoplasty)

Definition

This surgery replaces part of a diseased or damaged cornea with a healthy one from a donor. The cornea is the clear, outer surface on the front of the eye.

Cornea of the Eye
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Reasons for Procedure

This surgery is done to correct vision problems caused by infections, injuries, or health problems that affect the cornea, such as:

  • Keratoconus—a thinning and bulging of the cornea that causes blurred vision
  • A cornea scarred from infection or injury
  • Clouding of the cornea
  • Complications from a past eye surgery

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Excess bleeding
  • Problems from anesthesia, such as wheezing or sore throat
  • Infection
  • Blood clots
  • Rejection of the new cornea
  • Glaucoma
  • Problems with focus
  • Light sensitivity
  • Detachment of the retina
  • Cataract

Things that may raise the risk of problems are:

What to Expect

Prior to Procedure

The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Arranging for a ride to and from surgery

Anesthesia

The doctor may give:

Description of Procedure

A surgical microscope will be used to view the eye during surgery. The damaged part of the cornea will be cut out. The new cornea will be placed in the opening and fastened with fine stitches. A patch and shield will be put over the eye.

Descemets stripping endothelial keratoplasty (DSEK) may be used for some types of corneal transplants. This method removes a smaller part of the cornea. It may result in faster healing and better vision.

How Long Will It Take?

1 to 2 hours

Will It Hurt?

Anesthesia will prevent pain during surgery. The eye may be red, irritated, and sensitive to light for a few days. Medicines and home care can help.

Average Hospital Stay

Most people go home the same day. If you have any problems, you may need to stay longer.

Post-procedure Care

At the Hospital or Clinic

After the procedure, the staff may give you:

  • Pain medicine
  • Steroid eye drops to ease inflammation
  • Antibiotic eye drops to lower the risk of infection
At Home

Vision is usually worse before it gets better. It will take several months for the eye to adjust to the new cornea. Some activities will be limited during recovery. You may need to ask for help with daily activities and delay your return to work.

Problems to Look Out For

Call the doctor if you are not getting better or you have:

  • Signs of infection, such as fever and chills
  • Pain that you cannot control with medicine
  • Changes in vision, including floaters and flashing lights
  • Lasting nausea or vomiting
  • New or worsening symptoms

If you think you have an emergency, call for medical help right away.

RESOURCES

Eye Bank Association of America  https://www.restoresight.org 

National Keratoconus Foundation  https://www.nkcf.org 

CANADIAN RESOURCES

Canadian National Institute for the Blind  https://www.cnib.ca 

Canadian Ophthalmological Society  https://www.cos-sco.ca 

References

Corneal conditions. National Eye Institute website. Available at: https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/corneal-conditions. Accessed April 5, 2022.

Corneal transplants. National Keratoconus Foundation website. Available at: http://www.nkcf.org/corneal-transplants. Accessed Accessed April 5, 2022.

Frequently asked questions. Eye Bank Association of America website. Available at: http://restoresight.org/wp-content/uploads/2015/07/Frequently-Asked-Questions.pdf. Accessed April 5, 2022.

Revision Information