Corneal graft surgery (or corneal transplantation) refers to procedures in which abnormal corneal tissue is removed from a patient’s eye and replaced by healthy donor cornea.
There are various reasons for carrying out this type of surgery and these include:
1. Vision improvement for conditions such as:
- Fuch’s endothelial dystrophy
- Corneal scarring following previous infection/injury
- Other corneal dystrophies
2. To preserve the integrity and shape of the eye such as in patients with corneal thinning
3. To improve the appearance of the eye
There are several different approaches to surgery. The operation can be carried out as a full-thickness corneal transplant or as a partial thickness lamellar transplant (anterior or posterior). In either case, donor material is sourced from the UK Transplant Authority, in advance of the surgery.
The operation is often carried out under general anaesthesia, or local anaesthesia with sedation (“twilight anaesthesia”). The donor cornea is prepared first and then the recipient patient cornea is also prepared. Depending upon the technique used, the donor cornea may/may not be stitched into place. The operation is done extremely carefully, taking between 45 and 120 minutes.
After the procedure is completed, you will be given a full explanation regarding post-operative drops and tablets and follow up care. Protective eye shields will have been placed over the treated eye to prevent you from rubbing your eye for the rest of the day and also whilst sleeping during the night.
During the early post-operative period it is important not to squeeze or rub the eyes. Antibiotic and anti-inflammatory drops are used to prevent infection and decrease inflammation.
After leaving the clinic, patients are encouraged to rest/sleep for a few hours. The majority of patients will have mild to moderate discomfort beginning a few hours after the surgical procedure and this usually disappears within 24 – 48 hours. However, to ensure that the majority of patients have as comfortable a period after treatment as possible, all patients are given painkilling tablets to be taken every 4 – 6 hours for 1-2 days.
Patients are usually seen 1 day, 1 week and 2 weeks after surgery. You will need to be off work for at least 2 weeks. Subsequent further consultations will also be required.
You will be using eye drops throughout this period of time and it usually takes several months for the vision to start stabilising.
If stitches were used, these will be removed in stages starting at around 9 months. Further surgery may be necessary to deal with large amounts of astigmatism.
Please note that although pterygium surgery (an eyelid lift) can be performed under local anaesthesia alone, local anaesthesia with safe, conscious intravenous sedation given by a very experienced and skilled consultant anaesthetist (commonly referred to as “twilight anaesthesia”) is also available where requested. This form of anaesthesia is extremely popular with our patients and the effects are reversed very quickly. It enables local anaesthetic injections to be given painlessly with little recollection of the surgery, and helps to keep patients calm, relaxed and comfortable. It also helps to prevent rises in blood pressure.
Any patients requiring general anaesthesia or who are unsuitable for surgery at our day case facility, the Face & Eye Clinic, will be treated by our surgeons in a local private hospital e.g.the new Private Wing of Manchester Royal Eye Hospital (The Manchester Centre for Vision – www.centre-for-vision.com) or the Alexandra Hospital in Cheadle.