In a corneal transplant (penetrating keratoplasty), tissue obtained from an eye donor is grafted onto the damaged or defective eye of the recipient. A corneal transplant often is needed because the clear front covering of the recipient's eye (cornea) is damaged by injury or diseases such as a cone-shaped bulge in the cornea (keratoconus) or ocular herpes.

The cornea is essential for good eye health because of its role in bending ( refracting) light rays into a point of focus in the interior back of the eye (retina) where images are processed.

Dangers of corneal transplant can include rejection of the donor tissue by the recipient's body, if the tissue is not a good match.

How Should I Prepare for Keratoplasty Eye Surgery?

Before your keratoplasty eye surgery you will have met with your surgeon who will discuss with you what is the surgery. During this session your medical history will be evaluated and your eyes will be tested. Likely tests will include measuring corneal thickness, refraction, and pupil dilation. Once you have gone through your evaluation, he will answer any further questions you may have. Afterwards, you can schedule an appointment for the keratoplasty eye surgery.

If you wear rigid gas permeable contact lenses, you should not wear them during the three weeks before keratoplasty eye surgery. Other types of contact lenses shouldn't be worn for at least three days prior to keratoplasty eye surgery. Be sure to bring your glasses to the surgery so your prescription can be reviewed.

On the day of your keratoplasty eye surgery, eat a light meal the night before going to the operation theater and take all of your prescribed medications. Do not wear eye makeup or have any bulky accessories in your hair that will interfere with positioning your head under the laser. If you do not feel well that morning, call the doctor's office to determine whether the keratoplasty eye surgery needs to be postponed

Discharge instructions for Keratoplasty patients

General information:

· You have a corneal graft, and as with any surgical procedure, you will have a recuperation period. After any operation and anesthesia, it is normal to experience a general weakness. You should regain your sense of well being over the next week.

· If you have a general anesthesia you will probably feel very tired and perhaps nauseating for the first 24 hours.

· It is advisable to have someone stay with you for the first 24 hours following surgery.

· Some surgeons use two types of sutures around the cornea. The first type is removed in 3-4 months; the remainders are removed when healing is complete.

Care for your eye:

· It is normal to have a small amount of discharge on your eye lids, especially when you awaken. As your eyes heals, the amount of discharge should decrease.

· Each morning and whenever you find necessary, you should gently clean your eyelids, using warm water and clean tissue, without any pressure on the eye ball.

· Wipe the lids from the inside corner of the eyes towards your ear.

· You should protect your eye from external injury by taping a cotton pad over your eye and: wearing either glasses or an eye shield over the pad

· When sleeping you should tape the pad and shield over your eye. Your surgeon will advise you when this is not necessary.

Pain management:

· It is normal to feel some eye discomfort and/or itchiness. You can take pain medications as ordered by your surgeon as needed.

Activity:

· Do not directly pump or rub your eyes.

· Maintain a sedentary life style: read, watch TV, go for a walk

· Avoid straining, don't push or lift heavy objects, for at least 6 weeks or as ordered by the surgeon

· Do not do a strenuous sport, or activity

· Do not drive an automobile until your surgeon advises to

· Avoid lying on the surgery side

· Avoid constipation or severe cough

· Avoid getting direct tab water in the eye; you can shampoo your hair cautiously, or with the help of someone else, in the first two weeks. After that you can cover your eye with a shield during your bath time, for some time later as ordered by the surgeon.

· Avoid environment that may cause irritation to your eye, like smoking or perfumes or dust.

· You may resume normal sexual activity in 6 weeks.

Follow up:

· Your vision should gradually improve but will not be completely functional until healing occurs in 12 months.

· You should notify your doctor if you experience any of the following:

Any significant change in vision

Sudden eye pain or photophobia

Floaters or flashes

Significant tearing and discomfort

· Graft rejection may occur any time or even after years, so follow up appointments as given should be strictly followed.

· Please take all your medications/drops in your visits of follow up.