Corneal transplant operation

Corneal transplantation requires a referral. When we receive your referral, we will send you an invitation to the Corneal and Anterior Segment Surgery Unit for examinations by an ophthalmologist.

In the ophthalmologist’s examinations, we determine what eye disease we are dealing with and whether corneal transplantation can improve the patient’s vision. If corneal transplantation is a suitable form of treatment, we will place you on the corneal transplant waiting list. 

During your ophthalmologist’s examinations, you will receive instructions on corneal transplant surgery along with the telephone number of the Eye Bank. You can call the Eye Bank on weekdays between 8:00 a.m. and 3:00 p.m. to inquire when you will be able to have the surgery. The waiting time for corneal transplantation varies from a few months to six months.

Corneal transplant surgery is usually performed under local anesthesia, i.e. the patient is awake during surgery and in their own clothes. Cataract surgery can be combined with corneal transplantation.

If corneal transplantation is a well-justified treatment for both eyes, then one eye is treated at a time. Once the sutures of the previously operated eye have been removed and changes in the eye’s vision have stopped, the surgery for the other eye can be planned.

Pain medication

After surgery, the eye may feel a little sore and there may be a small hematoma and mild pain. At home, eye pain can be relieved with prescription-free pain medication from the pharmacy. If the eye pain is not relieved by pain medication, please contact the Corneal and Anterior Segment Surgery Unit by phone or, during on-call time, contact the Emergency Outpatient Clinic for Eye Diseases.

Eyedrops

After surgery, antibiotic and cortisone eyedrops are used according to a separate instruction. The physician will also prescribe lubricating eyedrops after a corneal transplant surgery to ease the potential feeling of dryness in the operated eye. If drops that reduce intraocular pressure have been used before surgery, their use will also continue after surgery.

Postural therapy

Postural therapy in the supine position is part of the treatment instructions after layered keratoplasty, i.e., corneal transplant surgeries. In order for the graft to attach, postural therapy will be carried out from a few days to a week or in accordance with the physician’s instructions.

Other instructions

• At the hospital, you will receive a protective shield to take with you to protect the operated eye for a month during sleep. You must not rub or apply pressure on the operated eye.
• Clean the eyelids of the operated eye daily for a month after surgery.
• You can take a shower, but avoid getting water in the operated eye. You can go to the sauna or go swimming four weeks after the surgery.
• Eye makeup can be worn when two weeks have passed after the operation.
• Avoid physical exertion for two months after a penetrating and layered keratoplasty procedure. After endothelial keratoplasty procedures, physical exertion should be avoided for a month. You can do normal light domestic work and carry light loads.
• After surgery, you can wear eyeglasses and sunglasses.

Control visits at an ophthalmologist

After your corneal transplant surgery, you will have regular control visits with the ophthalmologist. During these visits, we monitor the rehabilitation of your vision and, if necessary, adjust the dosage of eyedrops.

In a corneal transplant graft rejection reaction, the defense system of the transplant recipient’s body attacks the corneal graft, leading to opacification of the corneal graft and possible retransplantation. A rejection reaction of a corneal graft is rare.

Symptoms of rejection include:

• impaired vision
• eye pain
• redness of the eye
• photophobia.

If the rejection reaction is detected in time, it can be stopped with topical medication. If you notice any of these symptoms, please contact your treatment unit immediately.

Corneal transplantation can restore vision when a patient’s own cornea has been damaged or become opacified due to illness or infection. There is a constant shortage of corneal grafts.

A corneal donor can only be a deceased person. At HUS Eye Diseases, corneal donations are performed in HUS hospitals or hospitals maintained by the City of Helsinki. Good care of terminal patients in intensive care and emergency departments always includes determination whether the patient is suitable for corneal donation in order to help patients waiting for corneal transplantation.

According to the Human Tissue Act (Section 9, 24 June 2010), the tissues of a deceased person may be harvested, if they have not objected to it during their lifetime. A potential donor’s willingness for tissue donation is confirmed with the relatives before the cornea is removed. The Eye Bank operates in corneal harvesting in accordance with the Human Tissue Act and Fimea’s instructions.

Most of the corneas in the Eye Bank are harvested by the Eye Bank harvesting team. Some corneas are ordered from Regea Cell and Tissue Center, a clinical tissue bank in Tampere offering many types of tissues. The corneas used by the Eye Bank are all domestic.

A blood sample will be taken from the corneal donor to ensure that they have no infectious diseases. Corneas can only be used for corneal transplant surgery after donor blood samples and corneal fungal and bacterial cultures have been found to be negative. If the samples receive a positive test result, the grafts will not be used at all.