Having corneal surgery
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| A transplanted cornea. This patient also has nuclear cataract. |
The following is intended to provide an overview for patients having corneal transplant surgery under Dr McKellar's care at St George's Hospital.
For more specific information about corneal transplantation see Corneal disease-Surgical treatment.
The surgery itself
All transplantation is performed in a hospital theatre. Most surgery is performed under general anaesthesia. One night's stay is usually required. The operation is not very painful but the eye is often watery and sensitive to light for several weeks. It is reasonable to take a week off work.
Early post operative care
There are often some niggly problems in the first week or two. Leaks, loose sutures and pressure problems are the most common.
Eyedrops
Most patients will require eye drops for at least 18 months.
Long term care
Transplanted corneas need to be watched very carefully. Expect to see Dr. McKellar 10 times in the first year and yearly from then on.
Minor complications
Over the first few months one or more sutures may need removal. There may be pressure rises that can lead to glaucoma. This is usually managed with additional eye drops.
Major complications
The most common major complication is rejection. In most cases rejection can be treated successfully with intense eye drops and intravenous drugs. Rare complications include infection and failure of the graft to survive.
Suture removal
The cornea is very slow to heal so the stitches remain in place for approximately 18 months. Suture removal is a simple process that is performed at the rooms.
Visual recovery
The vision will usually be quite poor while the sutures are in place. It is common to only see the first two lines on the eye chart in the first 18 months.
Prognosis
The risk of corneal grafting depends primarily on why the surgery is required. Patients with keratoconus and corneal scarring have an excellent prognosis. Grafting is less successful in patients with Herpes eye disease.
Final visual outcome
It takes two years to achieve the final outcome. Most patients require glasses in order to see well. Often the very best vision is achieved only with a contact lens.