Once a medical rarity, corneal transplantation today is an accepted and reliable surgical modality for the rehabilitation of vision that has been compromised by corneal disease. It is estimated that over twenty thousand such procedures are performed annually in the United States alone. The increasing longevity of our population accounts for some of the increases in the number of these procedures due in part to the gradual loss of corneal clarity that can occur through the aging process. Many of the procedures are performed to correct corneal edema associated with commonly performed operative procedures such as cataract extraction and intraocular lens implantation.
The major indication for corneal transplantation surgery is to restore optical clarity. Among the conditions requiring such intervention are: corneal irregularity such as seen in scarring, corneal opacification as an aftermath of infectious disease or corneal contour abnormalities such as those seen with acquired thinning in a condition called keratoconus.
In corneal transplant surgery a diseased cornea is replaced with healthy tissue supplied by an eye bank. Prospective donor tissue is processed by the eye bank and checked for viability and health. Careful attention is directed to the screening of donors to prevent the spread of communicable diseases.
The art and science of corneal transplantation leaped light years forward with the introduction of Femtosecond laser technology. Dr. Fox is one of the only corneal surgeons in the metropolitan area offering Femtosecond laser corneal transplantation for those in need of corneal transplant surgery. With manual corneal transplant techniques of the past, the surgeon would make use of steel trephine blades and corneal punches to fashion the corneal donor tissue for transplantation. Inevitably such manual techniques would create a donor cornea that only approximated the intended shape on the patient’s cornea. This resulted in common problems including prolonged visual recovery, wound instability and lengthy periods of discomfort and disability and high levels of irregular astigmatism. With the advent of Femtosecond laser technology these concerns are now a thing of the past.
In general, the rehabilitation of vision following corneal transplantation can take a considerable amount of time and requires great skill on the part of the corneal surgeon. The healing process is carefully monitored and the new cornea treated with topical therapeutic agents to allow for the development of the best visual potential. Most patients can expect to enjoy considerable visual improvement beginning at three months following surgery with steady further improvement thereafter.