Transplant Surgery
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Getting on the list

When an ophthalmologist determines that a patient requires a cornea transplant, the patient's name is listed on the Eye-Bank's surgery schedule. This schedule gives priority to patients with emergency need followed by those who have been waiting the longest.

Preparing for Surgery

Prior to surgery, the patient is given laboratory tests that may include X-Rays, electrocardiogram, blood, urine and other eye tests. These are scheduled tests, done just prior to surgery. Patients are instructed not to eat or drink anything after midnight, the night before their scheduled surgery.

Surgery

Cornea transplant surgery may be performed under general or local anesthesia. The patient's face is cleansed/prepped and covered with sterile cloths. The surgeon performs the operation, which usually lasts between one and two hours, looking through a high-powered surgical microscope. During the surgery, the surgeon removes the patient's damaged cornea and replaces it with the clear, donor cornea. The donor cornea is then sewn into place with stitches (sutures) that are approximately one-third the thickness of a human hair.

After Surgery

After surgery, the patient's eye is patched with eye pads and covered with a metal or hard plastic shield to protect it from injury. The day after the surgery, the doctor examines the eye and usually puts the patch back on. Many patients are able to open their eyes and notice visual improvements immediately. Patients are allowed to eat something light as soon as they feel ready. Before going home, the patient is instructed on how to use the necessary medications, which may be ointments or eye drops, and given a medical schedule to follow.

Recovery

The early recovery period generally varies between one to three weeks following surgery. In this period, the patient should avoid rubbing his/her eyes and avoid any external contact with the eyes. Also any activity that will increase blood pressure to the head or the eye should also be avoided e.g. any activity that requires heavy lifting, bending the head lower than the waist; or any straining that requires holding ones breath should be avoided. Recipients should not undertake activities that require good vision (such as driving a car) while their eye is patched or until their vision is adequately restored. It is also very important for patients to keep every follow-up appointment with their doctor throughout the recovery period and to use medication exactly as prescribed.

Warning Signals

If the patient's body begins to reject the transplant or if any other problems occur, the situation can often be remedied if the patient contacts the doctor immediately. If a graft does fail, another cornea transplant is performed. Transplant recipients must watch for the following conditions:
  1. Redness of the eye. For the first few weeks after surgery, the eye will be red and become less red as time goes on. However, any substantial increase in redness or redness after recovery is cause to contact the doctor.
  2. Light Sensitivity. Some light sensitivity after surgery is expected and it should gradually decrease. If the eye becomes more sensitive to light than usual, the doctor should be notified.
  3. Vision Loss. Patients are advised to select an object at home to test their vision on every day. Changes in vision are expected, but if the check point appears more cloudy or blurred than in previous checks, the doctor must be called.
  4. Pain. Small twinges of pain during the healing process are expected. But the doctor must be notified if the eye hurts or throbs steadily for more than two or three hours.