About The Cornea
The cornea is the clear part in the front of the eye. It allows light to pass through to the retina unobstructed. The curvature of the cornea bends the light rays and focuses them on the retina, producing clear images in normal vision. Disease or trauma to the cornea can alter its structure and cause vision loss. Changes in corneal shape, thickness, or clarity cause poor vision that can often be corrected with a corneal transplant.
Corneal Transplant Surgery
During Cornea Transplant Surgery, a circle of tissue about 8mm in diameter is removed from the patient’s cornea. It is replaced with corneal tissue from a human donor. The donor tissue is carefully screened to prevent transmission of disease to the recipient. The new donor cornea is stitched into position using very thin nylon thread. The sutures are barely visible and do not cause pain, although it is normal for the eye to feel scratchy or irritated for the first few days after surgery.
For the first few weeks after the surgery, the vision is usually blurry. After several weeks, the vision begins to clear. Within 3 or 4 months, new spectacles can be prescribed, which often sharpen the vision even more.
As with any type of surgery, there are risks in corneal transplant surgery. Infection or bleeding in the eye can be very serious problems, but rarely occur. Other risks include cataracts, retinal detachment, glaucoma, donor failure, and donor rejection. Most of these complications can be repaired surgically or controlled with medications. The doctor will discuss these risks in detail prior to surgery.
Corneal Transplant Pre-op, Post-op and Recovery
Pre-op: Prior to being accepted for transplant surgery at Corneal Associates, you will need to undergo a thorough eye exam to confirm that you will benefit from surgery. You are likely to be examined by more than one doctor. As with any surgery, it is best for you to be well rested and well hydrated before the procedure. You will also need to arrange for a family member or friend to escort you home after the procedure.
Post-op: After the procedure, you will need to take it easy for several days. It is essential that you take the medicated drops prescribed to diminish the chances of infection. The stitches used in the procedure will be removed a few at a time. You will need to return to Corneal Associates several times.
Recovery: It will take about 9 months for you to recover fully. During that time, you will need to protect the eye as much as possible with dark or shaded glasses. You will make several return visits to Corneal Associates so we can monitor your progress and remove stitches. In most cases, we are able to tell patients that they are fully recovered in 9 months to one year. In a few cases, we perform enhancements to remove scar tissue, and the recovery period can be longer.
Double Running Sutures
Corneal transplantation has evolved into a highly successful procedure. About 90% of patients experience improvement in their vision following this procedure. This surgery is usually performed on an outpatient basis, meaning patients do not have to spend the night in the hospital.
Dr. Perl may use a double running suture technique on his patients undergoing penetrating keratoplasty (PK). Double running sutures may lead to faster restoration of visual function in eyes that have undergone penetrating keratoplasty. The technique uses two continuous, parallel running 10-0 and 11-0 nylon sutures. Typically, the 10-0 suture is removed at eight to 12 weeks, which can allow for early visual restoration. Double running sutures also allow for better wound closure, fewer wound leaks, less astigmatism and lower incidence of rejection since the 11-0 thread is so fine and essentially inert.