Corneal transplantation, or keratoplasty, replaces the damaged cornea with a healthy one from a donor. It is a low-risk procedure and is the most common type of transplant surgery that has the highest success rate.
During a corneal transplant, a circular incision is made in the cornea. A disc of tissue is removed and replaced with healthy tissue. Local and/or general anesthesia may be used. The entire procedure lasts between 30-90 minutes.
Corneal transplantation is an alternative treatment to INTACS prescription inserts and rigid gas-permeable contact lenses for patients with keratoconus.
DSAEK is the latest technique in corneal transplantation. Short for
Descemet-Stripping Automated Endothelial Keratoplasty, DSAEK offers clear post-operative vision and short recovery time to patients in need of new corneas.
During the procedure, the surgeon makes a mark in the surface of the patient's cornea with a trephine (an instrument used to cut circular sections of tissue). That mark serves two purposes: it helps the surgeon determine what size the transplant should be, as well as outlining the area of the patient's cornea that needs to be peeled away. Next, the surgeon scores the damaged section of the cornea and strips the membrane away from the eye. The donor cornea is folded into a "taco" shape and placed on the eye. Only a single stitch is needed to close this incision.
Sometimes the new cornea unfolds on its own; other times, the surgeon unfolds it him/herself. When it is unfolded, a second stitch is made to close the wound and anchor the new cornea in place. The surgeon then injects an air bubble underneath the cornea, making sure it is centered on the eye.
Patients are sent to the recovery room for about one hour, after which they are examined at the slit lamp with the doctor. He or she gently presses on the cornea until most of the air bubble is released. Patients are then given antibiotics and steroid eye drops and asked to return the next day for a follow-up appointment.
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