What is the cornea?
Your eye has a number of layers. The cornea is the transparent (clear), dome-shaped outer layer in front of the black pupil and coloured iris. Sometimes the cornea can become diseased, causing it to become less clear. This affects your vision.
How does the cornea become diseased?
There are many causes for the cornea becoming diseased. Three common causes need surgery.
Keratoconus – A condition where the cornea becomes cone-shaped, causing blurred vision.
Endothelial decompensation – A condition that causes the cornea to become swollen and cloudy.
Scarring – The cornea can become scarred if you have a serious infection or injury that causes inflammation.
What are the benefits of surgery?
This type of surgery could improve your vision.
Are there any alternatives to surgery?
Different types of glasses and contact lenses may help.If you have endothelial decompensation, eye drops may be helpful.
What does the procedure involve?
Various anaesthetic techniques are possible, including a general anaesthetic or a local anaesthetic that is injected around your eye to numb it. The operation usually takes 1 to 2 hours.
Your surgeon will remove the centre part of your diseased cornea and replace it with a part of a cornea from a donor (someone who has died). Your surgeon may replace all of your cornea (penetrating keratoplasty), the outer layers (deep lamellar keratoplasty) or just the inner layer (endothelial keratoplasty). Your surgeon will use small stitches to seal your eye.
What complications can happen?
Like all surgical procedures, there are some levels of risks to consider. Some of these can be serious and can even cause death. However, you can speak to your doctor about the following general and specific complications that may worry you.
General complications of any operation
Specific complications of this operation
- Heavy bleeding inside your eye
- Inflammation in your other eye
- Leak at your wound
- Transferring infection from the donor
- Increase in eye pressure
- Failure of the transplant
How soon will I recover?
You should be able to go home the same day or the day after. The healthcare team will give you eye drops and sometimes medication to take home. Do not swim or lift anything heavy until you have checked with your surgeon. Regular exercise should help you to return to normal activities as soon as possible.
Before you start exercising, ask the healthcare team or your GP for advice. Most people make a good recovery. It may take up to 2 years for your vision to improve. You may need to have an operation to change the shape of the cornea.
The healthcare team will arrange for you to come back to the clinic regularly so they can check that the transplant is healing well and for signs of rejection.
Disease of the cornea is a common problem that causes the transparent outer layer of the front of your eye to become less clear. If other treatments do not help, a corneal transplant can be performed to improve your vision. To find out more, call us on 0808 101 0337.
Author: Prof Anthony King MD FRCOphth
Illustrator: Medical Illustration Copyright © Nucleus Medical Art. All