Do Cornea Transplants Work?

Cornea transplants are one of the most common transplants you can undergo and are second only to blood transfusions. Unlike other organ transplants, cornea transplants are relatively low-risk and minimally invasive. 

In almost all cases, only a section of the cornea is removed and replaced with donor tissue. Because only a small amount of donor tissue is used, the risk of rejection is lower than it is for most other transplant procedures.

For the most part, cornea transplants are indeed successful. There are risks involved, as there are with any surgical procedure or transplant, but an experienced surgeon can reduce these risks. 

More importantly, cornea transplants are sometimes the only way to restore a patient’s vision when there’s significant damage to the cornea.

Keep reading to learn more about cornea transplants, their necessity, and their surgical techniques.

What is a Cornea Transplant?

A cornea transplant, or keratoplasty, is a surgical procedure that replaces part of the cornea with corneal tissue from a donor. The cornea is the transparent front part of the eye that refracts the light that passes through your eye so you can see clearly. 

When the cornea is damaged, your vision becomes warped. Once damaged to a significant degree, you can go completely blind. 

If your cornea is damaged to this degree, keratoplasty is often the only way to save your vision.  

Reasons for Undergoing a Cornea Transplant

There are many reasons you may need a cornea transplant. A cornea transplant can restore vision loss from eye conditions like:

  • Keratoconus
  • Fuch’s dystrophy 
  • Severe corneal ulcers/corneal scarring from ulcers
  • Corneal scarring from injury
  • Corneal swelling
  • Severe corneal thinning/tearing

You can treat some of these eye conditions with less invasive methods, at least in the early stages. However, once significant damage to the cornea occurs, the only way to restore vision loss is to replace the damaged cornea with healthy donor tissue.

Types of Cornea Transplants

There are several kinds of cornea transplants. Each uses a slightly different surgical technique. 

Some techniques are less invasive and carry a smaller risk of complications. However, to understand how each method works, you first need to understand the different layers of the cornea.

The cornea has several layers. On the top is a thin protective layer called the epithelium. 

Underneath that is a thinner layer called Bowman’s layer. Under this layer is the thickest layer that makes up most of the cornea, called the stroma. 

Below the stroma is another very thin layer called Descemet’s membrane, and below that is the final layer, called the endothelium. Different types of keratoplasty replace further layers of the cornea. There are three main types:

Penetrating Keratoplasty

A penetrating keratoplasty replaces all layers of the cornea. This technique is only used when the cornea is badly damaged. 

But the entire cornea is rarely replaced. Instead, the diseased or damaged section is excised as a circle, and a circle of donor tissue is grafted in. 

Endothelial Keratoplasty

An endothelial keratoplasty replaces only the bottom layers of the cornea. This usually includes both the endothelium and Descemet’s membrane.

Anterior Lamellar Keratoplasty

An anterior lamellar keratoplasty (ALK) removes only the top corneal layers. It may only replace the epithelium and Bowman’s layer, a superficial anterior lamellar keratoplasty (SALK). 

It may also extend into the stroma, which is called a deep anterior lamellar keratoplasty (DALK). What kind of corneal transplant you have depends on what part of your cornea is damaged. 

An endothelial keratoplasty may be appropriate if the endothelial layer is the issue, as is often the case for Fuch’s dystrophy. But if the epithelial layer and the stroma are the primary issues, as is often the case with keratoconus, an anterior lamellar keratoplasty may be most appropriate. 

However, you may need a penetrating keratoplasty to treat even these conditions if the damage to the cornea is significant enough. Most of the time, your surgeon can use less invasive keratoplasty techniques to minimize recovery time and risk of tissue rejection.

What to Expect From Your Cornea Transplant

Cornea transplants of all kinds are usually successful. They’re often performed as outpatient procedures, meaning you can go home the same day they are performed after they are over. 

General anesthesia is also not required, further minimizing the risks of the procedures. Eye drops can completely numb the cornea to ensure the procedure is painless. 

Most patients also receive mild sedatives to help them relax during the procedure. Depending on the cornea transplant you undergo, you may be able to experience total vision restoration. 

However, this depends on the severity of vision loss. If it’s more severe, you may only experience partial restoration. 

You may require corrective lenses to see clearly again. It may also take time for your vision to return as your eyes heal from the corneal transplant.

The most significant risk of corneal transplant is rejection. Rejection is a risk after any transplant. However, the risk is smaller with corneal transplants because less tissue is used and transplanted. 

This risk is minimized further by taking immunosuppressants, which are often prescribed alongside other post-surgical medications to aid in recovery.

Cornea transplants usually work quite well for patients requiring them. Do you think you may need a corneal transplant? Learn more by requesting an appointment at New England Eye Center in Boston, MA, now!

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