What is the cornea? The cornea is the clear front window of the eye that allows light to enter the eye and helps us see clearly.
Common Reasons for a Cornea Transplant - Keratoconus, Fuchs’ Dystrophy, Bullous Keratopathy, trauma, failure/ rejection of previous transplant, and corneal scarring (trauma, ulcer, herpetic, etc.).
Keratoconus
Fuchs’ Dystrophy
Herpes Simplex
Keratoconus - hereditary, degenerative corneal disease characterized by generalized thinning and cone-shaped protrusion of the central cornea.
Fuchs’ Dystrophy - progressive disorder characterized by endothelial outgrowths on Descemet’s membrane, waterlogged cornea, epithelial blisters. The endothelial layer helps pump fluid out of the cornea- keeping it thin and clear. If this pump isn’t functioning properly the cornea begins to swell, and the more swelling the cornea has, the more blurred the vision can become.
Bullous Keratopathy - degenerative process characterized by small blister-like pockets that form in the swollen epithelial layer and permanent swelling of the cornea.
Herpes Simplex - virus that recurrently infects the cornea, producing branch-like ulcers (dendrites). This can lead to a larger ulcer or scarring of the cornea.
Types of Transplants - Standard Penetrating Keratoplasty (PKP), Descemet’s Stripping Endothelial Keratoplasty (DSEK)
New cornea held in place by sutures
PKP - conventional corneal transplant where the patient’s cornea is removed and replaced with donated corneal tissue from a cadaver. The new donated cornea is held in place by many sutures, which will remain in place for months to years following the surgery. These sutures are removed slowly over several office visits.
DSEK - An incision is made into the cornea and the back portion of the cornea is stripped away and replaced by a similar piece of healthy tissue from a cadaver donor.
Advantages to DSEK: single suture, reducing the amount of post-operative astigmatism and allowing for faster recovery of vision.
FAQ -
Do I have to be placed on a waiting list to have a transplant?
-No, cornea transplants are very common and the tissue can be shipped overnight to any location.
Do I have to worry about matching my blood type, or any infectious diseases passed from the donor?
-No, the cornea is asvascular (without blood vessels) so there is no need to match a blood type. The eye bank screens all donor tissues for viruses that cause AIDS, syphilis, and hepatitis, along with other neurological diseases.
Will I have to be on anti-rejection medications?
-Yes, you will be prescribed a steroid eye drop to be used daily to prevent rejection. This eye drop will most likely be used for years following the surgery.
Will I know if my cornea is rejecting?
-Some symptoms of rejection are persistent redness, sensitivity to light, vision changes, or pain. If you have any one, or combination, of these symptoms that occur for more than 48 hours contact your ophthalmologist
