Corneal Transplant

Surgery | Success | Treatment

What is a Cornea Transplant?

A cornea transplant, which replaces damaged tissue on the eye’s clear surface, is also referred to as a corneal transplant, keratoplasty, penetrating keratoplasty (PK), or corneal graft.

A cornea transplant replaces central corneal tissue, damaged due to disease or injury, with healthy corneal tissue donated from an eye bank. An unhealthy cornea affects your vision by scattering light and causing blurred or distorted vision. In some cases, a cornea can be so damaged or scarred that a transplant is necessary to restore your functional vision. Cornea transplants are performed routinely. In fact, of all tissue transplants, the corneal transplant is the most successful. The National Keratoconus Foundation estimates that more than 40,000 cornea transplants are performed in the United States each year.

Remember that in most cases, after cornea transplant surgery, medically necessary contact lenses will be required.

Cornea Surgery

Penetrating (full thickness) cornea transplant. This involves transplanting all the layers of the cornea from the donor.

Lamellar cornea transplant. During this procedure, the surgeon only replaces some of the layers of the cornea with the transplant.

In a lamellar cornea transplant, selected layers are transplanted, which can include the deepest layer, called the endothelium (posterior lamellar cornea transplant). Commonly performed versions of this procedure include Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK) or Descemet’s Membrane Endothelial Keratoplasty (DMEK).

Success Rates of Corneal Transplants

Experts know more about the long-term success rates of penetrating cornea transplants, which use all the layers of the cornea.

Success rates are also affected by the problem that needed to be fixed with the transplant. For example, research has found that the new cornea lasts for at least 10 years in:

  • 89% of people with keratoconus
  • 73% of people with Fuchs’ dystrophy
  • 60% to 70% of people with corneal scarring

Contact Lens Treatments for Corneal Transplants

Although a successful cornea transplant provides the eye with a clear optical surface, the patient can be left with regular or irregular astigmatism, aphakia, anisometropia, or traumatic mydriasis. The good news: contact lens wear can address and resolve many of these residual anomalies, maximizing a patient’s postoperative vision potential.

Because a transplanted cornea is irregularly shaped, glasses do not adequately correct the vision since they cannot conform to the shape of the eye. Patients with a cornea transplant see best with rigid contact lenses since these lenses provide a clear surface in front of the cornea, allowing the light rays to be projected clearly to the retina. Hence, the vast majority of patients are treated with rigid contact lenses. In the past, small diameter rigid gas permeable lens were the first choice after a cornea transplant. However, the comfort was poor, the lenses often popped out of the eye, and outdoor activities were limited.

The best, modern, and most comfortable contact lenses available are scleral lenses and our doctors are the experts. These contact lenses allow our doctors to customize the contact lenses for the best vision and comfort. These lenses allow our patients to be active and participate in outdoor activities, even on a dusty or windy day. Most patients report these are as comfortable as soft contact lenses and, often, the most comfortable contact lenses ever! They have a constant fluid reservoir and provide comfort for the dry eye symptoms after a cornea transplant.