Corneal transplantation, also referred to as a “penetrating keratoplasty”, replaces the clear membrane which covers the surface of the eye. It is performed in an outpatient surgical setting at the hospital, typically under a local anesthetic with the eye completely numb. Corneal tissue for the operation is harvested from a donor shortly before their death. As with all transplants, there is a possibility of the body rejecting the donor corneal tissue, however, due to the reduced blood supply to the cornea this risk of graft rejection is low. Full visual recovery may take a long time with corneal transplant, sometimes in excess of a year. Most transplants result in significant astigmatism and therefore may require some type of contact lens following the surgery. Success rates are typically above 90% and many patients enjoy years of successful vision following the procedure.
What about DSEK?
A new alternative to traditional corneal transplantation is Descemet’s Stripping Endothelial Keratoplasty (DSEK). The advantages of DSEK over traditional corneal transplant include a stronger wound, rapid healing time, less chance of suture abscess or ulceration, and little change in the post-operative refraction. This new procedure does not replace the entire cornea, but only its inner lining. This requires fewer stitches and allows for much faster healing, approximately 1 month vs. one year with traditional surgery. DSEK is limited to specific diagnoses, but this new technology is fast becoming the procedure of choice for a select group of corneal transplant patients.