What is a corneal graft?
A corneal graft is an operation performed in which abnormal corneal tissue is replaced by donor corneal tissue.
Why would a corneal graft be required?
The cornea which is the clear window at the front of the eye may have become cloudy or opaque, or cone-shaped (keratoconus) rather than spherical, causing visual problems. Sometimes surgery is required because of severe infection, or if the existing cornea has become too thin.
What should I bring with me on the day of my operation?
Please bring any eye drops and your medication, your glasses, reading lease bring any eye drops and your medication, your glasses, reading.
How long will I be in the hospital?
You may be discharged from hospital on the same day of surgery, or you may be kept in hospital overnight.
What type of anaesthetic do I have?
This operation can be done under local or general anaesthetic. This will be discussed at your pre-operative assessment visit.
How long does the surgery take?
The operation can take one to one and a half hour approximately.
How is the operation done?
Much of the unhealthy cornea is removed. It is replaced with donor corneal tissue and may be held in position with up to 16 fine stitches.
Will there be any discomfort?
You may have a little discomfort after the procedure. Please take your usual pain relief tablets.
Will I have eye drops following the operation?
Several types of eye drops will be prescribed. These will need to be put in your eyes for some time after your operation. This may be for many months.
Are there any risks?
The body can reject the donor cornea. If this happens the cornea will become cloudy, the eye may be red, painful and light sensitive. This is quite a common problem following corneal transplant surgery but is often dealt with effectively by prompt treatment. It is very important that you contact the eye centre if your vision suddenly decreases or you have discomfort in the eye (including light sensitivity) and the eye becomes red and sore. Graft rejection can sometimes lead to failure of the graft.
Some other potential complications include:
- Primary graft failure – The donor graft does not survive the procedure and remains cloudy. Surgery may need to be repeated.
- Astigmatism – Focusing error due to asymmetry in the shape of the cornea.
- Glaucoma – Damage to the optic nerve resulting in peripheral vision loss, often due to raised pressure in the eye.
- Cataract – The original condition, corneal transplant surgery or the long-term use of steroid drops the following surgery, may all contribute to the development/progression of cataract. This condition (clouding of the lens in the eye) can usually be dealt with by a separate surgical procedure.
- Uveitis – inflammation of the layers in the eye.
- Wound dehiscence – the surgical wound can re-open and this may require more stitches. It is important to note that the eye is weakened and particularly vulnerable to injury (especially blunt trauma, such as a blow to the eye) following corneal transplant surgery.
- Endophthalmitis – An uncommon but severe (usually painful) infection inside the eye which may lead to blindness. This is treated with antibiotics but the outcome can be poor and may even lead to loss of the eye.
- Detached retina- Peeling off of the light-sensitive layer at the back of the eye, this usually requires further surgery to repair.
- Severe bleeding – Bleeding inside the eye which may require further surgery.
- Loss of vision – There is a risk of blindness or even loss of eye if this occurs.
When are the stitches removed?
The stitches are removed at least 6 months after your operation. This is done in the theatre in the eye centre under local anaesthetic. Loose or broken stitches will need to be removed promptly. It can take up to 18 months to remove all stitches and achieve the final improvement in your sight.
