If the cornea becomes cloudy as a result of corneal disease, the only way to restore sight is to replace or transplant the cornea. Corneal transplantation (Penetrating Keratoplasty) is the most successful of all tissue transplants. An estimated 30,000 corneal transplants are performed each year in the United States. A newer type of corneal transplant surgery called Descemet's Stripping Automated Endothelial Keratoplasty (DSAEK) is a tremendous advancement over traditional transplant surgery and, for many patients, results in faster healing and improvement in vision.
What to expect on surgery day:
You will arrive at the Surgery Center one hour prior to your procedure. Once you have been checked in you may be offered a sedative to help you relax. You will then be prepared for surgery. The area around your eyes will be cleaned and a sterile drape may be applied around your eye. Your eye will be numbed with local anesthetics and you will receive additional sedation through your IV.
When your eye is completely numb, an eyelid relaxer will be placed between your eyelids to keep you from blinking during the procedure. Your diseased cornea will be removed with a special round tool called a trephine. Then the donor cornea will be cut to a matching size, placed upon your eye and secured in place with very fine sutures. Your eye will be patched or shielded after surgery. The surgery itself is painless and usually done on an outpatient basis. The operating time is approximately 45-60 minutes, followed by a short recovery time. You will be allowed to go home soon afterward. You should relax for the rest of the day. You may experience some discomfort for a few days.
Eye drops and pain medication can be used to minimize this discomfort. Everyone heals differently, but most patients resume activities within a few days. Strenuous activity such as lifting, bending or straining should be avoided for several weeks. To protect your eyes from inadvertent trauma, you will be advised to wear shields, glasses, or sunglasses while your eye heals. The healing process can take many months. Often, the stitches are not removed until six to nine months after surgery. This is a brief, painless procedure. During that time, medicated eye drops will be used to make sure the transplant heals properly.