Today, in Northern Colorado, we have some of the most amazing eye surgeries available. A corneal transplant – also calledkeratoplasty (KP), penetrating keratoplasty (PKP), or corneal graft – is the surgical removal of the central portion of the cornea (the normally clear front surface of the eye) followed by replacement with a donor “button” of clear corneal tissue donated from an eye bank.
When people in Northern Colorado have vision impairment due to injury or disease that cannot be corrected with LASIK, eyeglasses, contact lenses they look at the corneal transplant option.
The National Eye Institute states that there are around 40,000 corneal transplants are performed each year in the United States. The success rate for keratoplasty is quite high. When signs of rejection do happen to occur, doctors treat them with an aggressive medical treatment of steroids that most times can overcome the reaction and preserve the cornea. There are some studies that report keratoplasty success rates of 95% to 99% at 5 to 10 years after surgery.
Reasons for corneal transplants
Here in Northern Colorado, a very common cause for keratoplasty is keratoconus, which is a degenerative condition where the cornea thins and bulges forward in an irregular cone shape. In some mild cases, keratoconus can be treated with rigid gas permeable (GP) contact lenses.
The more advanced the condition is in the eye of the patient, the more difficult it is to treat with contact lenses and eventually it becomes impossible to treat with contact lenses. Vision with GP lenses also becomes unacceptable because of the great amount of corneal irregularity in advanced stages. According to the National Keratoconus Foundation, 20 to 25% of patients with keratoconus will require corneal transplant surgery to restore vision.
Some of the other indications for keratoplasty include traumatic injuries to the eye and corneal scarring from infections, chemical burns or other causes. Corneal ectasia (thinning and bulging of the cornea that is similar to keratoconus) which can occur after a LASIK or other laser vision procedure may require a corneal transplant to correct this complication.
The corneal transplant procedure
Generally, corneal transplants are performed on an outpatient basis so you would not need to be overnight in the hospital. Each patient’s health and Local or general anesthesia is used, depending on your health, age and whether or not you prefer to be asleep during the procedure. The surgeon will use an instrument called a trephine (an instrument like a cookie cutter) or a laser to cut and remove a circular area of damaged or diseased tissue in the center of your cornea, and then will replaces it with the clear donor tissue.
The donor “button” of donor tissue is then attached to your remaining cornea with super fine sutures (less than half the thickness of a single human hair). These special sutures stay in place for months or even years, until your eye is completely healed and recovered.
Recovering from a corneal transplant
The total recovery time for a corneal transplant may be up to a year or longer depending on the age and wellness of the individual patient. At first, after the surgery your vision will be blurred and the site of your corneal transplant will most likely be swollen and a little thicker than the rest of your cornea. Eye drops that will help to promote healing and aid your body in accepting the new corneal graft will be needed for several months after your surgery.
A couple of tips for post surgery:
- You should keep your eye protected all the time post surgery by wearing a shield or a pair of eyeglasses. You do not want anything to inadvertently bump your eye.
- As your vision improves, you will gradually be able to return to your normal daily activities this will take time and is a process.
Vision after keratoplasty
Some patients in Fort Collins, Loveland and Greeley notice a real improvement in their vision the day following their procedure. Large amounts of astigmatism are very common in patients after a corneal transplant. Your vision and eyeglasses prescription will most likely change and change again for months post surgery, these vision adjustments may continue for up to a year.
Gas permeable contact lenses generally give the best vision correction option after keratoplasty, as some irregularity of the corneal surface is common. Glasses with polycarbonate lenses should be worn over the contact lenses for eye protection.
After healing from the surgery is complete and the sutures are removed, it might be possible to have LASIK or some other laser vision correction procedure to reduce astigmatism and improve your vision without the use of glasses or contact lenses.
For additional information or to schedule an appointment, please call 970-204-4020 or click on the link on the side of the page.