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Corneal Transplants

Corneal Transplant Pentrating keratoplasty (“PK”) involves removing the central area of a patient's cornea and replacing it with a donor cornea. Since there are no blood vessels in the cornea, the transplanted tissue does not have to be “matched” or blood typed. The corneal donor tissue can be stored for up to two weeks and is held in various eye banks to be dispensed to needy recipients. Because donor tissue is stored at an eye bank, we can typically schedule your surgery in advance, anticipating the tissue will be available when needed. A cornea transplant can reduce pain and improve the appearance of a damaged or diseased cornea, as well as restore vision

A cornea transplant can treat a number of conditions including:

  • Thinning of the cornea (Keratoconus)
  • Cornea scarring (caused by infection or injury)
  • Corneal ulcers and complications caused by previous eye surgery

The surgery is a same-day procedure and takes about an hour. Prior to surgery, the patient is given a light intravenous sedative and the eye is anesthetized. A circular cutting device, called a trephine, is placed over the cornea and is used by Dr. Walter to cut the host cornea, which removes a circular disc of the patient cornea. The trephine is then removed and Dr. Walter cuts a circular graft, referred to as a "button,” from the donor cornea. Once this is complete, Dr. Walter returns to the patient's eye and removes the host cornea. Then, the donor cornea is brought into the surgical field and maneuvered into place with forceps. Once the donor cornea is in place, Dr. Walter will fasten the cornea to the eye with stitches. Antibiotic eye drops are administered and the eye is patched. Once the effects of anesthesia wear off, the patient typically goes home, and returns to see Dr. Walter the following day for his or her first post-operative appointment. The eye patch is used to shield and protect the eye immediately after surgery, and particularly to prevent eye rubbing at night, but is removed the next day at the post-operative appointment. Most patients are asked to limit strenuous physical activities until healing has occurred and clinic visits are scheduled to assess healing and remove the sutures. The recovery after this procedure is longer than with other eye surgeries and can take one or two years to obtain good vision. In most cases, patients who receive a corneal transplant will have their vision at least partially restored, but results depend on your health conditions and age.

Typically, the patient will meet with Dr. Walter for an examination in the weeks or months preceding the surgery. During the exam, the eye will be examined and Dr. Walter will diagnose the condition. He will discuss different treatment options available and the risks and benefits of the various options. Because your risk of complications and cornea rejection continues for years after your cornea transplant, you should expect to see your routine eye doctor annually. Medications can often manage cornea rejection.

Once the outer layer of your cornea has healed, Dr. Walter will work to make adjustments that can improve your vision, such as:

  • Correcting astigmatism, an unevenness in your cornea. The stitches that hold the donor cornea in place on your eye may cause dips and bumps in your cornea that can create blurry spots in your vision. Dr. Walter may release some stitches to correct the blurry spots in your vision but about 60-70% of patients require hard contact lenses to see 20/20.
  • Contact lenses can be fitted between 6 months and one year after surgery.
  • Glasses are required in nearly 100% of cases and are typically fitted after 6 months, or once the cornea shape has stabilized. These may be in addition to contact lenses for best vision at all ranges.