What is a corneal transplant?

A corneal transplant is a surgical procedure in which a damaged cornea is replaced with a healthy one from a donor. The cornea is the outermost lens of the eye, and because of its transparency and high optical capacity, it must remain clear to allow normal vision.

When is a corneal transplant needed?

There are several corneal conditions that require a transplant to restore vision. These include trauma, infections (particularly herpes and scarring conjunctivitis), and corneal deformities (the most common being keratoconus), among others.

What does the surgery involve?

In recent years, eye surgery has reached a high level of effectiveness and relative comfort. Corneal transplantation is considered the most successful of all organ and tissue transplants, with techniques constantly improving.

The procedure involves removing the central portion of the patient’s damaged cornea and replacing it with a clear donor cornea. It is a meticulous operation performed under a surgical microscope, using sutures finer than a human hair.

Typically, the procedure is performed under local anesthesia on an outpatient basis. Surgery lasts between 40 to 90 minutes depending on the case. Post-operatively, the operated eye is usually covered for about 3 to 5 days.

What results can be expected from surgery?

Outcomes depend largely on the underlying condition. In keratoconus, results are generally very good, while in multi-injured eyes (from trauma or complications of prior surgeries) expectations are more guarded. It is important to note that additional procedures—such as cataract removal, intraocular lens implantation, or vitrectomy—may be performed alongside a corneal transplant.

Because the cornea is such a sensitive optical element, it is almost always the case that some refractive error remains. Depending on the situation, this may require correction with glasses, contact lenses, or refractive surgery.

In cases where the first transplant fails and the donor cornea becomes opaque, a second transplant may be the solution.

What post-operative care is required?

Some patients experience mild discomfort or irritation in the eye after surgery. Recovery time varies by occupation, but generally 10–15 days of rest are recommended.

After the bandage is removed, vision is not immediately clear. It may take several weeks or even months for vision to stabilize enough for corrective glasses or contact lenses to be prescribed.

Is rejection possible?

First, it is important to understand that corneal rejection does not mean the donor cornea is expelled or lost. Instead, it occurs when the recipient’s immune system attacks the transplanted cornea, causing it to become cloudy.

The risk of rejection is lower than for any other transplanted human organ, since the cornea has no blood vessels. Rejection of other organs usually happens due to incompatibility between donor and recipient, mediated by blood cells.

While a corneal graft can be rejected, in most cases medications can reverse rejection and preserve the transplant—provided treatment is given in time.

How safe are donor corneas?

By law, donor corneas must be tested for possible contagious diseases. In addition, each cornea is evaluated for quality and preserved in a special medium that keeps it viable for up to seven days.

Donor corneas are carefully reviewed by the surgeon, who makes the final decision on whether or not to use them.