Normally, patients use the words ‘eye transplant’. However, like other organ or tissue transplant surgeries, an actual eye transplant is not possible yet. Even with the help of current modern tools and equipment, eye doctors cannot transplant the entire eye through surgery. It is not possible to remove the whole eye from an individual and transplant it into another patient to improve eye condition or vision.

Cornea Transplant

Currently, the only procedure for eye transplant that is available to the eye patients is the ‘cornea transplant’ (keratoplasty). It is a surgical procedure in which whole or part of the cornea is replaced with corneal tissue from a dead donor.

Why is corneal transplant done?

In the majority of cases, corneal transplant procedures are carried out to restore vision. This procedure may also improve the appearance of damaged or diseased eye cornea, relieve pain or other symptoms associated with corneal diseases. There are many eye conditions which can be treated with corneal transplant surgery which includes:

  • Keratoconus

  • Fuchs’ endothelial dystrophy (advanced)

  • Corneal scarring

  • Corneal ulcers

  • Complications caused by a previous ophthalmic surgery

  • Risks

Although corneal transplant is an effective and safe procedure, it still carries risks of complications. These include:

  • Eye infection

  • Rejection of the donor cornea

  • Suboptimal vision

  • Cataract

  • Glaucoma

  • Problems with the stitches

The outcome of corneal transplant

Types of Cornea Transplant

There are mainly three types of cornea transplant. Your ophthalmologist will suggest the best procedure as per the need depending on your corneal problem.

Types of corneal transplant are

DALK – Deep Anterior Lamellar Keratoplasty:

It removes the top 4 layers of the cornea leaving the last layer intact. In this procedure, the eye doctor injects air to lift the corneal layers and separates the outer layers of the cornea. Then, the surgeon removes and replaces these layers. DALK is a common procedure for people with corneal scar and keratoconus. The healing time of this procedure is shorter than other types of keratoplasty.

EK – Endothelial Keratoplasty:

The surgeon replaces only the innermost layer of the cornea in this surgery. Endothelial keratoplasty is suitable for those people who have corneal endothelial dystrophies and other conditions that affect the corneal endothelial layer. In this surgery, the air bubble is used to hold and support the new endothelium layer inside the cornea. The structural integrity of the eye is better maintained as only single layer is replaced. Also astigmatism is lesser compared to other keratoplasties.

PK – Penetrating Keratoplasty:

It is also known as ‘full thickness’ transplant. In this process, the whole cornea is replaced by the donor’s cornea. The cornea is held in place with 16 or more stitches. Penetrating keratoplasty is carried out if the patient had a DALK transplant and that hasn’t worked or the endothelial and stroma corneal layers are damaged. After this surgery, the stitches are not removed till 3 or more months usually. The vision improves during the healing process, but the patient needs more than a year for complete healing of the transplant.

Finding a Donor Cornea

Corneas used in corneal transplants are from deceased donors. Many healthy people specifically donate their corneas which are then easily available for donation after they die. Corneas from donors who had adverse health or eye conditions are not used.

Recovery:

Your eye doctor may prescribe eye drops to reduce the chances of infection and inflammation. Along with eye drops, some medications can be prescribed to deal with pain. Do not miss the post-surgical checkup. Your doctor may schedule your eye appointments several times during the following weeks, and frequent visits with minimal medication during the first year. Eye drops may be needed for more than a year based on the corneal graft status. Follow the eye surgeon’s

instructions carefully and protect the eye from any kind of injury.

A corneal transplant can help in a dramatic improvement in vision.  Your contact lens or glasses prescription may need to be adjusted after the surgery.

Dr. Swapnali Sabhapandit

Dr. Swapnali Sabhapandit

MS, FLVPEI Cornea Specialist at Neoretina
Dr. Swapnali completed her MBBS from Gauhati Medical College, Guwahati, Assam. She did her MS (2004-2007) from the Regional Institute of Ophthalmology, Guwahati, Assam. She did clinical Cornea and Anterior Segment Fellowships from Aravind Eye Hospital, Pondicherry and subsequently from LV Prasad Eye Institute, Hyderabad. Dr. Swapnali is a skilled surgeon and her special interests include LASIK and refractive surgeries, management of keratoconus and corneal transplant surgeries.
Dr. Swapnali Sabhapandit

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