Corneal Transplant

When are cornea transplants recommended? 

The cornea is the clear dome at the front of the eye that helps focus light and facilitate clear vision. When the cornea becomes so swollen or irreparably damaged that eye drops are no longer effective, your ophthalmologist may recommend a cornea transplant. 

The types of conditions that cause this type of damage to the cornea include: 

• Corneal dystrophy, a condition that causes an abnormal buildup in the cornea
• Eye disease or infection
• Injury or scarring from trauma or surgery
• Keratoconus
• Corneal swelling or edema
• Previous corneal transplant failure

Good candidates for a cornea transplant typically experience impaired vision from one of the causes above that can’t be treated with less invasive techniques. 

What is a cornea transplant?

A cornea transplant involves removing the damaged tissue of your cornea and replacing it with healthy corneal tissue from a human donor. The donor tissue is extensively screened by eyebanks and only suitable donor material is transplanted.

Recent advances in corneal transplant surgery have improved the safety and visual recovery time of this surgery. There are four main types of corneal transplantation offered:

Penetrating Keratoplasty (PKP)

During this procedure, your doctor removes the full thickness damaged cornea and sews in the donor cornea.

Deep Anterior Lamellar Keratoplasty (DALK)

During this procedure, the surgical experts at Fuerst Eye Center remove the front layers of the cornea but leave the thin innermost layer (descemet’s membrane) intact. The donor cornea is sewn on top of descemet’s membrane.

Descemet Stripping Endothelial Keratoplasty (DSEK)

In DSEK, the innermost layer of the cornea is replaced with donor tissue, leaving 90% of your native cornea. DSEK is indicated in diseases affecting the innermost, endothelial layer.

Descemet Membrane Endothelial Keratoplasty (DMEK)

DMEK is the most advanced form of partial corneal transplant procedure indicated in diseases affecting the innermost, endothelial layer of the cornea. It is similar to DSEK but is a much thinner tissue allowing for an exact anatomical replacement of the damaged cells.

Dr. David Fuerst and Dr. Nicole Fuerst use the most advanced transplant technologies to create a customized treatment for you. The ophthalmologists can detect exactly which layers of the cornea are affected, whether it’s the outer layer, inner layers, or the entire cornea.

What happens during a cornea transplant?

First, your surgeon provides local or general anesthesia and IV sedation, depending on your preferences and the extent of the surgery. Once the anesthesia takes effect, your doctor inserts a speculum to hold your eyelids open during the surgery.

Next, your doctor measures the affected area in order to prepare the area and the donor tissue. With traditional surgery, your doctor cuts away a section of damaged tissue and sutures a new section of donor tissue in its place. With endothelial keratoplasty, your surgeon makes a tiny incision, removes your damaged tissue and places a thin disc of donor tissue at the back of the cornea, leaving the healthy tissue intact.

Post-operative healing times and visual recovery vary depending on which type of transplant was performed. After DSEK and DMEK, it is important to lie flat on your back to help the transplant tissue stick to your cornea. A full-thickness transplant (PKP) takes longer to heal and eye protection – a shield, glasses, or sunglasses – is worn for at least 30 days to protect the eye from inadvertent trauma after surgery. 

If you’re interested in learning about your options for cornea repair, contact the providers at Fuerst Eye Center by phone, or request an appointment online today.