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A Vision-Saving Surgery

A cornea transplant, or penetrating keratoplasty (PK), is a surgical procedure to replace part of your cornea with corneal tissue from a donor. Your cornea is the transparent, dome-shaped surface of your eye that accounts for a large part of your eye’s focusing ability. A PK can restore vision, reduce pain, and improve the appearance of a damaged or diseased cornea. Corneal transplants are typically performed as an outpatient procedure. Over 95% of PKs are successful; however, the surgery carries a small risk of complications, such as rejection of the donor cornea. A PK is most often performed to restore vision to a person who has a scarred cornea. PKs may also relieve pain or other signs and symptoms associated with diseases of the cornea.

Cornea transplant
Cornea Transplant Conditions

Conditions That Can Be Treated with a Cornea Transplant

  • A pathologic bulging out of the cornea (keratoconus)
  • Thinning of the cornea
  • Cornea scarring, caused by infection or injury
  • Clouding of the cornea
  • Swelling of the cornea
  • Corneal ulcers, including those caused by infection
  • Complications caused by previous eye surgery

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Corneal Transplant Complications and Risks

Penetrating keratoplasty is a relatively safe procedure.  Still, a PK does carry a small risk of serious complications, such as:

  • Eye infection
  • Increased risk of clouding of the eye’s lens (cataracts)
  • Pressure increase within the eyeball (a form of glaucoma)
  • Problems with the sutures used to secure the donor cornea
  • Rejection of the donor cornea
  • Swelling of the cornea

In some cases, your body’s immune system may mistakenly attack the donor cornea.  This is called a rejection and will require management or even another cornea transplant.  It is important to note that early diagnosis and treatment of rejections oftentimes reverse the process allowing for complete recovery.

Where Do Corneal Transplants Come From?

Corneas used in PKs come from deceased donors. Unlike other organs, such as livers and kidneys, people needing a PK generally do not have to be placed on a “donor list.” This is because nearly all people can donate their corneas after they die, so more corneas are available for transplant compared with other organs. In addition, blood typing and matching is not necessary since the cornea is avascular (lacking blood supply). Therefore, rejection is not based upon mismatched donors and recipients.

What to Expect on The Day of Surgery

On the day of your PK, you’ll be given sedatives to help you relax and a local anesthetic to numb your eye. You may or may not be asleep during the surgery, but you will not feel any pain. During the cornea transplant, your surgeon cuts through the entire thickness of the abnormal or diseased cornea to remove a small button-sized disc of corneal tissue. An instrument that acts like a cookie cutter (trephine) is used to make this precise circular cut. The donor cornea, cut to fit, is placed in the opening. Your surgeon then uses a fine suture to stitch the new cornea into place.

The sutures will be removed at a later visit when you see your eye doctor.

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