Corneal transplants are used to correct vision when the corneal tissue has been significantly damaged. During the procedure, a full or partial thickness of corneal tissue is removed and replaced with donor tissue. Dr. Brian Boxer Wachler has specialty fellowship training in corneal surgery, and in the past has used corneal transplant surgery to help many Los Angeles patients, as well as patients from across the U.S. and around the world, to preserve and recover vision.
When Are Corneal Transplants Needed?
The corneal transplant procedure is reserved for patients who corneal tissue has deteriorated to the extent that it cannot heal, and vision is being significantly affected. The conditions that can require this surgery include:
- Keratoconus (bulging of the cornea)
- Thinning or torn cornea
- Fuchs’ Dystrophy
- Corneal scarring due to injury or infection
- Infection or inflammation for a previous eye surgery
- Corneal ulcers that do not respond to treatment
- Corneal swelling
In addition to restoring vision, a corneal transplant can also relieve the pain or swelling of a damaged cornea.
Corneal Transplant Procedure Details
The most common type of corneal transplant procedure involves removal of a segment of the full thickness of the cornea. A piece of donor tissue is precisely cut to fit and then stitched in place. The stitches dissolve over time and the donor tissue merges with the existing cornea. This procedure is also known as penetrating keratoplasty or corneal graph.
Partial Thickness Corneal Transplants
Several types of procedures are used to remove and replace a portion of the corneal thickness. These include ALK (anterior lamellar keratoplasty), during which an anterior layer of corneal tissue is removed and replaced, and EK (endothelial keratoplasty), during which a posterior layer is removed and replaced. The choice and extent of the procedure is determined by the location and depth of the corneal tissue damage.
Complications
Corneal transplant surgery is a safe procedure. As with surgeries, there is a risk of complications. Infection is a possibility. Rejection of the donor tissue is a possible complication when the immune system incorrectly recognizes the donor tissue as foreign to the body and does not allow the tissue to merge with the existing cornea. This process can cause detachment of the new cornea (also known as tissue rejection). Increasing pressure in the eye (glaucoma) sometimes occurs after the procedure. Also, development of cataracts can occur.
Corneal Transplant Recovery
After the procedure, you will receive several medications for pain and swelling. Also, specialized medication is used to suppress the immune system and block the rejection of the donor cornea. Most patients experience some level of vision recovery after a corneal transplant procedure. The recovery depends on the extent of the cornea damage, the amount of vision loss prior to the procedure and how well the eye adapts to the donor tissue.
Schedule an Appointment
If you have been told you need a corneal transplant or if you suffer from the conditions described above, including keratoconus, a torn or damaged cornea, or infection from a previous surgery, then you should schedule an appointment. Dr. Brian will work with you to determine the health status of your cornea, whether a corneal transplant is needed, and which type of procedure best suits your eye care needs.
