Cornea sub-specialists diagnose and treat the many varied conditions of the anterior segment (front) of the eye. The cornea trained ophthalmologist specializes in penetrating keratoplasty (PKP), commonly known as a corneal transplant, as well as a variety of excisional and grafting procedures of the front of the eye.

The Corneal Transplantation Procedure

A complete pre-operative evaluation will be required prior to surgery. The surgeon will make every attempt to confirm retinal and optic nerve function prior to surgery, so as to avoid cases in which visual improvement is unlikely.

The majority of adult patients may be operated on under local anesthesia. General anesthesia will likely be required for children, anxious, or uncooperative patients. After the anesthetic is given, the surgeon usually sews a ring to the ocular surface to support the eye. The donor cornea is prepared using a punch or corneal trephine to create the corneal "button." The corneal button will become the transplanted cornea. The diseased, or scarred, cornea is then removed using a corneal trephine, creating a "bed" for the transplant cornea. Finally, the donor cornea is gently sewn into place with ultra-fine sutures (approx. one-third the thickness of human hair, or less).

Before	After

Corneal transplantation may be combined with other procedures, particularly cataract extraction with intraocular lens implantation.

Postoperatively, patients should expect very gradual recovery of vision. In fact, the best vision may not be obtained for six to 12 months or more following surgery, even though vision may be improved from the first day after surgery in some cases. The surgeon will likely begin to remove some sutures from the cornea within a few weeks to a few months after surgery. However, all of the sutures need not be removed. In general, sutures are removed to help alleviate astigmatism once the cornea begins to show signs of being securely healed into place.