The cornea is the clear window covering the front of the eye which bends or refracts light rays that focus on the retina in the back of the eye. A certain shape or curvature is required in order for light to focus exactly on the retina, rather than in front of it or behind it or in a single point of focus.
An improperly curved cornea, as with patients with keratoconus, may be corrected with contacts or with other surgical procedures, such as Cornea Collagen Crosslinking with Riboflavin with or without INTACS.
Cornea transplantation, or Keratoplasty, is recommended when the cornea’s curvature is too steep or flat to be treated with contacts or other surgical methods.
During the procedure, a circular incision is made in the cornea. A disc of tissue is removed and replaced with healthy tissue. There are several different corneal transplant procedures available to help restore vision in patients with keratoconus. The traditional corneal transplant procedure involves replacing the entire damaged cornea with a healthy one from a human donor, which is usually obtained from an eye bank. However, technological advances have allowed for the development of specialized procedures that replace only the damaged part of the cornea. Local or general anesthesia may be used. The entire procedure usually lasts about 90 minutes.
While a cornea transplant is the most common type of transplant surgery and carries fewer risks compared to other transplants, it is not something that should be considered until all other options have been exhausted. There are certain risks involved with cornea transplant, the most common include infection, loss of vision, rejection of transplant, prolonged redness, sensitivity to light, prolong blurred vision, inability to wear contacts, premature cataract development and more. Patients considering a cornea transplant should discuss with their surgeon all possible risks. The recovery of a cornea transplant is frequently painful and long. It can take 6-12 months for full rehabilitation. This is the reason this procedure is the last resort for keratoconus after other options have been explored.
With the development of advanced modern day keratoconus treatments, cornea transplants are performed less and less often. An experienced cornea specialist will determine whether or not a cornea transplant is the right option after a thorough evaluation and discussion of other options.