Why would someone need a corneal transplant?
The cornea of your eye can be damaged through routine activities, sports or at work. Please contact Dr. Croley in Ocala, FL if you believe your cornea or eye has been damaged in any way. Corneal injury, disease or hereditary conditions can cause clouding, distortion and scarring on the cornea, the clear front window of the eye. Corneal clouding looks like frost on a windowpane and blocks the clear passage of light to the back of the eye, reducing sight. In addition, corneal injury and disease can be painful, sometimes the most intense pain experienced.
If the cornea becomes cloudy and doesn’t respond to other treatment, the only way to restore sight is to replace (transplant) the cornea. Fortunately, corneal transplantation or keratoplasty is the most successful of all tissue transplants.
What is the cornea?
Your cornea is the transparent, dome-shaped surface of your eye that accounts for a large part of the eye’s focusing power and ability. A healthy, clear cornea is essential for good vision.
How does the doctor get a new cornea for me?
Corneal tissue for transplant comes from an eye bank. Names of patients needing corneal transplants are placed on a waiting list until tissue becomes available from corneal donors. Dr. Croley is then offered the corneal tissue and reviews all reports prior to accepting or rejecting a cornea for his patients.
What is a corneal transplant?
A corneal transplant is a surgical procedure that replaces part of your cornea with corneal tissue from a donor. There are two main types of cornea transplants, clinically known as keratoplasty — full thickness cornea transplant and back layer cornea transplant.
Who is a candidate for a corneal transplant?
Corneal eye disease is the fourth most common cause of blindness. It affects over 10 million people worldwide. If your cornea is damaged due to disease or injury, it can become swollen, scarred, or severely misshapen and this distorts your vision. A cornea transplant could be necessary if eyeglasses or contact lenses can no longer correct the vision enough to be functional. Sometimes, painful swelling can also dictate a transplant.
These are some conditions that can be treated with a corneal transplant:
- An outwardly bulging cornea
- Fuch’s dystrophy
- A thinning cornea
- Clouding of the cornea
- Cornea scarring from injury or infection
- Swelling of the cornea
- Corneal ulcers
- Complications from previous eye surgery
How do I prepare for a corneal transplant?
Prior to your surgery, Dr. Croley will give you a thorough eye exam to be sure your eye doesn’t have conditions that may cause rejection of the new cornea tissue. He’ll measure your eye to determine the size of cornea you need. If there are other eye conditions, such as an eye infection or inflammation, these will need to be cleared up before any transplant surgery can be considered.
Unlike other organ transplants, where there can be a lengthy wait time for donor organs, this is not usually a problem with cornea transplants. Many people have opted to become eye donors upon their death.
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What can I expect from a corneal transplant?
Prior to your surgery, you’ll be given a sedative. You’ll be awake during the procedure but your eye will have local anesthetic, so you won’t feel anything.
In the most common type of cornea transplant, Dr. Croley cuts through the entire thickness of the abnormal or diseased cornea to remove a circular disk of tissue. To precisely make this cut, Dr. Croley uses a trephine that will make the circular button-sized cut.
Now the donor cornea is cut to fit the same size and is placed is the space of the removed circle of tissue. Dr. Croley stitches this new cornea into place and the procedure is complete.
In some patients, full-thickness cornea transplants aren’t the way to go. These procedures remove certain layers of cornea tissue, either the back layers or front layers, which are then replaced with donor tissue.
What is the recovery time for a corneal transplant?
Recovery after a cornea transplant takes time, up to a year or even longer. In the beginning, your vision will likely be even worse than it was prior because your eye takes time to get used to the new cornea. Your vision will improve and you’ll begin returning to your normal routines. Most patients can return to work within a week after surgery, depending on your job and how quickly your vision begins to improve.
You’ll need to be careful with lifting, as you need to avoid increasing blood pressure to the head and face. Heavy, strenuous exercise and lifting are prohibited for a number of weeks; Dr. Croley will discuss this with you.
You’ll use steroid eye drops for several months after your transplant to help your body accept the new corneal graft. You’ll also need to protect your eye at all times with either a shield or eyeglasses; you can’t inadvertently bump your eye.
What are the risks/side effects of a corneal transplant?
There are the usual risks that accompany any surgery, such as infection. But with cornea transplant, the biggest risk is that your body will reject the donor cornea. Rejection of donor tissue occurs in up to 30 percent of patients, and it occurs when your body believes the new tissue is a foreign body and attacks it.
If you recognize the warning signs of tissue rejection, however, graft failure can often be prevented. To remember what to look for use the acronym RSVP:
- Extreme Sensitivity to light
- Decreased Vision
The possibility of rejection can last for years after your surgery; that’s why steroid drops are used. If and signs of rejection are detected early, the graft is successful around 90 percent of the time.
What is the success rate for corneal transplants?
Success rates of corneal transplants are very high and continue to increase with new techniques and better eye bank protocols. If the patient can avoid rejection (or at least see the signs to reverse it early), success rates for this surgery are around 90 percent. It is one of the most successful of all tissue transplants in the body.
Will I need vision correction after this surgery?
Once the outer layer of your cornea has healed, Dr. Croley can work with you to make adjustments to further improve your vision.
- Astigmatism — The stitches that hold your donor tissue in place can sometimes cause dips and bumps in your cornea, making your vision blurry in spots. He can release some stitches and tighten others to address this.
- Refractive errors — Just as with eyes that don’t have a cornea transplant, refractive errors such as nearsightedness and farsightedness can be corrected with glasses, contact lenses, or even LASIK/PRK surgery in some cases.
What should I understand about the surgery?
The surgery consists of a transfer of the clear central part of the cornea from the donor’s eye to the patient’s eye. Soon after the operation, the patient can walk around and resume activity. The procedure takes about 1-2 hours. Dr. Croley performs this outpatient surgery at Central Florida Eye Institute in Ocala. Your ability to drive and do other activities will be discussed at your pre-operative appointment prior to your surgery. You will be put on eye drops for several weeks. You will need to return to see Dr. Croley for several post operative appointments.
How long until I can see well again?
Return of best vision after corneal transplant may take up to a year after the surgery depending on the rate of healing and the health of the rest of the eye. Each patient if different, all your individual medical conditions and daily needs are unique and will be considered so that you are completely informed prior to your procedure.
Central Florida Eye Institute proudly offers the Ocala, Gainesville, Lady Lake, Leesburg, and Inverness, Florida area corneal transplant surgery. For more information call (352) 237-8400 or visit our Contact Us page to request a consultation today!