Having a Cornea Transplant

A cornea transplant is a procedure that replaces a damaged or diseased cornea with healthy corneal tissue from a donor. The cornea is the eye’s outermost layer. It is a clear layer on the front of your eye. The cornea helps your eye to focus incoming light, so you can see clearly and distinctly. It also helps protect your eye from dirt and germs.

What to tell your healthcare provider

Tell your healthcare provider about all the medicines you take. This includes over-the-counter medicines such as ibuprofen. It also includes vitamins, herbs, and other supplements. And tell your healthcare provider if you:

• Have had any recent changes in your health, such as an infection or fever

• Are sensitive or allergic to any medicines, latex, tape, or anesthesia (local and general)

• Are pregnant or think you may be pregnant

• Have a history of:

  • Eye infections

  • Eye surgery or an eye-related injury

  • Retinal disease

  • Scarring of the cornea (corneal opacity)

  • Lazy eye (amblyopia)

  • Nutrition problems

  • Conditions like diabetes, hypertension, or a collagen vascular disorder

Tests before your procedure

You may need some special eye exams before your procedure.

Your healthcare provider may want to use special tools to shine a light in your eye and look at your cornea. You may need to have your eyes dilated for this eye exam. You also may need computerized corneal mapping. This will give your healthcare provider more information about your cornea.

Getting ready for your procedure

Talk with your healthcare provider about how to get ready for your surgery. You may need to stop taking some medicines before the procedure, such as blood thinners and aspirin. If you smoke, you may need to stop before your surgery. Smoking can delay healing. Talk with your healthcare provider if you need help to stop smoking.

Also make sure to:

• Ask a family member or friend to take you home from the hospital. You cannot drive yourself. You may also need help for a few days after the surgery.

• Follow any directions you are given for not eating or drinking before your surgery.

• Follow all other instructions from your healthcare provider.

You will be asked to sign a consent form that gives your OK to do the procedure. Read the form carefully. Ask questions before you sign if something is not clear.

On the day of your procedure

Your procedure will be done by an eye surgeon. The surgery can be done in several ways. Ask your healthcare provider about the details of your surgery. In general, you can expect:

• You may have general anesthesia to put you to sleep. If this is the case, you will sleep through the surgery. Or you may be awake during the surgery. You will get medicine to help you relax. You may also be given anesthetic eye drops and injections. These are to make sure that you don’t feel anything during the procedure.

• Your surgeon will use special tools to keep your eye open during the surgery. They will remove the entire thickness or just the inner layer of the central part of your damaged cornea. They will then replace it with healthy donor tissue.

• The surgeon may use very fine stitches (sutures) to sew the donor cornea in place. Or an air bubble will be put on your eye to keep the new cornea in place. This is used instead of sutures.

• The surgeon may put an antibiotic ointment on your eye. This is to help prevent infection.

• The surgeon will close your eye and cover it with a bandage.

After your procedure

You may be able to go home the same day. Plan to have someone go home with you after the procedure. You may not be able to see well right away because of eye swelling. Make sure you:

• Follow all your healthcare provider’s instructions.

• Don't rub or press your eyes.

• Use antibiotic eye drops if told to. These are to help prevent infection.

• Take over-the-counter pain medicine if needed. Your eye may be a little sore after the procedure.

• Wear an eye patch, eye shield, or glasses to protect your eye as it heals.

• Take all prescribed medicine as directed. You may be given medicine to prevent rejection of your new cornea. Or you may be given eye drops to reduce swelling, inflammation, and irritation.

• Lie on your back for a while after the surgery if your provider tells you to do so. You may need to do this if your surgery used an air bubble to hold the donated cornea in place. It may take a few days for the air bubble to be absorbed.

• Ask your provider what activities not to do as you recover. They may tell you:

  • Don't do any strenuous exercise or heavy lifting.

  • Stay away from smoky or dusty places to prevent eye irritation.

  • Don't swim or participate in contact sports until your provider tells you it's safe. Always wear protective goggles when resuming contact sports.

  • Don't drive until your provider tells you it's OK to do so.

  • Don't get water in your eye for at least a month.

Follow-up care

Make sure to keep all your follow-up appointments. You will need close follow-up care so your healthcare provider can see if the procedure worked. You may have an appointment the day after the procedure. If your surgeon placed stitches during the procedure, they will be removed at a follow-up visit.

Your cornea will need time to heal. It may take weeks to months for your vision to return. Your recovery depends on things like the type of surgery you had and your overall health. To prevent complications, continue to visit your healthcare provider at least once or twice a year. Also continue to take any medicines that your provider prescribes.

When to call your healthcare provider

Call your healthcare provider right away if you have:

• Decreased eyesight

• Eye redness that gets worse

• Eye pain that gets worse even after taking pain medicine

• Sensitivity to light that gets worse