Eye Doctor in Mesa, Arizona
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Eye Exams in Mesa, Arizona

Corneal Transplant - Mesa, Arizona.

East Valley Ophthalmology in Mesa, Arizona specializes in state-of-the-art corneal transplantation. Corneal transplantation, also known as corneal grafting or penetrating keratoplasty (PKP), is a surgical procedure where a damaged cornea is replaced by donated corneal tissue. For information beyond what is available on our website, please call: 480-981-6111.

Penetrating Keratoplasty (PKP)

cornea transplant arizona   corneal transplantation arizona

Penetrating keratoplasty (PKP) is full-thickness corneal transplant. It was first developed over 100 years ago and is now one of the most common transplant procedures. Although approximately 100,000 procedures are performed worldwide each year, some estimates report that 10,000,000 people are affected by various disorders that would benefit from corneal transplantation. In the United States, the cost is usually covered in part by Medicare and health insurers. Reimbursement depends on your personal healthcare provider.

Also see Partial-Thickness Corneal Transplant:
DSEK (Descemet's Stripping Endothelial Keratoplasty)

Indications

A corneal transplant is done for a variety of conditions that lead to poor vision. These include Fuchs' corneal dystrophy, bullous keratopathy, herpes keratitis, and sometimes ocular trauma. Indications for corneal transplantation include the following:

  • Optical: To improve visual acuity by replacing the opaque host tissue by clear healthy donor tissue. The most common indication in this category is pseudophakic bullous keratopathy, followed by keratoconus, corneal degeneration, keratoglobus and dystrophy, as well as scarring due to keratitis and trauma.
  • Tectonic/reconstructive: To preserve corneal anatomy and integrity in patients with stromal thinning and descemetoceles, or to reconstruct the anatomy of the eye, e.g. after corneal perforation.
  • Therapeutic: To remove inflamed corneal tissue unresponsive to treatment by antibiotics or anti-virals.
  • Cosmetic: To improve the appearance of patients with corneal scars that have given a whitish or opaque hue to the cornea.

Pre-operative Examination

At East Valley Ophthalmology, you will meet with your ophthalmologist for an examination in the weeks or months preceding your surgery. The doctor will examine your eye, make a diagnosis and, if indicated, order lab tests, such as blood work, X-rays, or an EKG. He will discuss the condition of your eye with you and the available treatments, including the risks and benefits of each. Your surgery date and time will be set, and you will sign a consent form and be told where the surgery will take place.

Procedure of Corneal Transplantation

On the day of the surgery, you will arrive to the outpatient surgery center, where the procedure will be performed. You will be given a brief physical examination by the surgical team and is taken to the operating room. In the OR, you will lie down on an operating table and either given general anesthesia, or local anesthesia and a sedative.

With anesthesia induced, the surgical team prepares the eye to be operated on and drapes the face around the eye. An eyelid speculum is placed to keep the lids open, and some lubrication is placed on the eye to prevent drying. A metal ring is then stitched to the sclera, which will provide a base for a trephine.

A trephine is then placed over the cornea and is used by the surgeon to cut the host cornea. The trephine is then removed and the surgeon cuts a circular graft (a "button") from the donor cornea. Once this is done, the surgeon returns to the eye and removes the host cornea.

The donor cornea is then brought into the surgical field and maneuvered into place with forceps. Once in place, the surgeon will fasten the cornea to the eye. The surgeon finishes up by reforming the anterior chamber with a sterile solution injected by a canula, then testing that it's watertight by placing a dye on the wound exterior.

With the metal ring removed and antibiotic eyedrops placed, the eye is patched, and you will be taken to a recovery area while the effects of the anesthesia wear off. You may go home following this and see the doctor the following day for your first post-operative appointment.

Prognosis of Corneal Transplantation

When the primary purpose of a cornea transplant is to improve visual acuity, the prognosis is dependent upon whether the rest of the eye is healthy. If it is, then it should be possible to recover normal vision. Full visual recovery can take 6 to 12 months.

Risks of Corneal Transplantation

Traditional corneal transplant surgery has about a 90% success rate, and the rate of rejection is only about 8%. Rejection episodes can often be controlled with topical steroid drops. Graft failure can occur at any time after the cornea has been transplanted, even years or decades later. The causes can vary, though it is usually due to new injury or illness. Treatment can be either medical or surgical, depending on the individual case.

Occasionally, there are problems with sutures, which can come loose, cause infections, or cause astigmatism. The astigmatism after traditional corneal transplant surgery can be significant enough that eyeglasses alone won't give adequate vision. These patients may ultimately require contact lenses or additional surgery to reduce or eliminate the astigmatism.

Because the wound is full-thickenss and 360 degrees, the corneal transplant wound is not as strong as normal. It is at risk to rupture or break open from mild or incidental trauma, even several years after the surgery.

While the cornea is avascular, there is still a potential for some blood loss, usually from suturing the metal ring to the sclera. Any blood loss is typically less than a teaspoon, or less than 2 cc.

There is also a risk of infection. Since the cornea has no blood vessels (it takes its nutrients from the aqueous humor) it heals much slower than a cut on the skin. While the wound is healing, it is possible that it might become infected by various microorganisms. This risk is minimized by antibiotic prophylaxis (using antibiotic eyedrops, even when no infection exists).

The eye specialists of East Valley Ophthalmology perform advanced technology diagnostic testing and treatment, as well as taking the time necessary to provide each patient with information needed to fully understand their condition and to achieve their best possible visual outcome.

If you would like further information, please call our office at:

480-981-6111

East Valley Ophthalmology

Eye Doctors - Mesa, Arizona

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East Valley Ophthalmology
5620 East Broadway Road
Mesa, Arizona 85206

Tel: +1-480-981-6111
FAX: +1-480-985-2426

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