Understanding the cornea

Prior to explaining a cornea transplants its worth a brief explanation and review of the cornea and its general function. The cornea is the very front surface of the eye or the outer surface of the eye. The cornea plays a major role in how you focus on images. In conjunction with your natural crystalline lens the cornea helps to provide required focusing power. If the cornea becomes weak or damaged serious visual problems may arise. Because the cornea is such an important part of your visual system please make sure to contact a qualified ophthalmologist if you think you might have damaged your cornea. Treating damaged or irregular corneas is something that is routinely done at Midshore Surgical Eye Center. Each damaged cornea requires special attention by our specialized cornea eye surgeons. Typically, we can start treating the cornea with medication. If your vision cannot be accurately corrected with medications, eyeglasses or contact lenses a corneal transplant may be required.

How does damage to the cornea occur?

Damage to the cornea may arise from various reasons such hereditary issues, chemical burns, blunt object trauma, viruses or bacteria. Conditions that may require a patient seek a cornea transplant involve, clouding of the cornea, keratoconus, fuchs dystrophy, irregular corneal surface tissue growths, or corneal swelling.

What is a corneal transplant?

A corneal transplant, also known as a corneal graft, or as a penetrating keratoplasty, involves the removal of the central portion (called a button) of the diseased cornea and replacing it with a matched donor button of cornea. Corneal grafts are performed on patients with damaged or scarred corneas that prevent acceptable vision. This may be due to corneal scarring from disease or trauma.

What is a cornea specialist?

A cornea specialist is an ophthalmologist who has undergone additional training and study of the cornea structure, diseases and related surgeries. Having an experienced cornea specialist ophthalmologist can increase the chances of a successful cornea surgery outcome.

Deciding when to have a corneal transplant

A common indication for keratoplasty is keratoconus. The eye-care practitioner must decide when to recommend keratoplasty for the keratoconic patient. This is often not a simple, straight-forward decision. Keratoplasty for keratoconus is highly successful; however, there is a long recovery period and a risk of severe ocular complications. A number of factors must be considered in deciding when to do a keratoplasty. One of the most important is the patient's functional vision. If the best acuity with their contact lenses prevents them from doing their job or carrying out their normal activities, a transplant must be considered. The actual measured visual acuity may be quite different for different patients. One patient may find that he/she can not do their job with 20/30 acuity while another patient may be very satisfied with 20/60 acuity.

Healing After Corneal Transplant

The healing process following transplant is long, often taking a year or longer. The time from surgery to the removal of the stitches is commonly 6 to 17 months. The patient may be on steroids for months. Initially following surgery the donor button is swollen and even following healing, the button is usually thicker than the corneal bed in which it rests. Patients are required to have routine check-ups after corneal transplant surgery.

To learn more about corneal transplants and corneal diseases, watch the video animations below.