Corneal Graft

The cornea is the clear outer layer at the front of the eye. The colored iris and the black pupil are seen through the cornea and it helps to focus and transmit light as it passes to the lens and on to the retina at the back of the eye. On reaching the retina, light is converted into impulses that are then transmitted via the optic nerve to the visual centre in the brain.

Corneal damage prevents light from passing adequately to the retina and causes the picture transmitted to the brain to become distorted.

When is a Corneal Graft recommended?

A corneal graft may be recommended when a damaged cornea cannot be improved by other treatment. Such grafts may alleviate pain, improve visual acuity, and repair perforations in ruptured corneas.

The source of corneas for transplantation come from the deceased, who have given consent (or whose family have consented) for the medical use of the eyes after death.

The process is stringently controlled and corneas are not taken from donors with infected conditions. Donors are meticulously screened for AIDS or hepatitis viruses before their corneas are approved for medical use.

In the event of a delay in obtaining a suitable cornea, the patient may have to wait for the death of an appropriate donor. Generally, patients are called to the hospital a day before the operation.

Before surgery is even considered, eyewear, eye drops or drugs will be the initial treatment.

What does the operation involve?

A patient’s eye is not removed during an operation. The central piece of poor cornea is cut through and removed. The donor’s cornea is then transplanted and sewn with very fine stitches, which can remain in place for up to two years. Usually, the cornea takes at least a year to heal and this will determine the length of time the stitches should remain intact.

Immediate post-surgery treatment is to cover the affected eye with an eye patch. This is removed the day after the operation, after which patients can resume normal activities according to their condition. Usually patients are home within a few days of the graft operation.

Are there post-surgery complications?

Sensitivity to light and blurred vision are usual post-operative symptoms. Sharp and clear vision is not immediate and for a few months there can be fluctuations in visual acuity. The shape of the cornea may not be exactly like the one it has replaced and corrective eyewear can be prescribed to correct the difference. Usually this is done several months after the operation because the cornea takes time to heal.

Rejection of the new cornea is a possibility and prompt treatment – even years later – is essential to prevent sight loss or a repeat graft. Redness of the eye, vision loss or pain are symptoms to be aware of.

Serious complications are uncommon but, as with all major eye operations, there will always be a risk of hemorrhaging or other damage. Complications include cataract or retinal detachment, or infection. It is important, in this respect, that regular visits to the ophthalmologist are maintained.

If the front of the eye is damaged by injury or disease, the prognosis for a corneal graft in terms of vision improvement is good generally.