Corneal Transplant Procedure, Alternatives and Complications

Corneal transplant also known as Penetrating Keratoplasty and Corneal Graft is the replacement of the part of the eye called the cornea with graft derived from a human donor.

Corneal transplants are routinely performed by Dr. Ilan Cohen in his New York and New Jersey offices. The cornea is the clear part in front of the eye responsible for transmission of light into the eye. Various disease processes can affect the health of the cornea and lead to a reduction in vision. These include: keratoconus, scarred cornea, corneal edema (swelling of the cornea) or a cornea infection often caused by contact lens wearing.

The Challenge:

The human cornea is responsible not only for the transmission of light into the eye, but is also a lens that focuses the light rays and has to posses a precise geometric configuration for a good vision. In order to understand how important and how delicate this configuration is; it is enough to mention that operations like LASIK can improve a patient’s vision significantly by making slight modifications to the shape of the cornea. These modifications are usually on the order of the microns (1/1000th of a millimeter). The minutest changes to the corneal surface can result in major shift in vision, for the good or the bad.

The outcome of a corneal transplant depends very much on how closely the donor tissue is matched to the recipient bed in shape and how well it is sutured together. It is not surprising therefore, that in the circle of corneal surgeons; surgical skill is synonymous with skill in corneal transplantation. Corneal transplantation requires skill and dexterity that is far beyond what is required in other types of eye surgery.

Laser Corneal Transplant:

In traditional corneal transplant, the surgeon uses a blade to cut the donor cornea and to prepare the host bed for transplantation. This is often the source of much of the mismatch and the reduction in post-operative vision. However, due to recent innovation Dr. Ilan Cohen has been able to adopt the same laser used for cutting the flap in LASIK, to cut the donor cornea and also to prepare the host bed for transplantation. This leads to some important improvements:

• Laser accuracy Increases physical compatibility between the donor and the recipient
• Laser allows the formation of shapes (donor and recipient) that can naturally fit into each other to prevent leakage from the eye post-operatively. This is not possible with manual blades.

Complications of corneal transplant:

The most common complication of a corneal transplant is a very high and irregular corneal astigmatism which can significantly limit the vision with and without glasses. Other complications include: post-operative leakage, rejection, graft failure and infection. Using the latest surgical techniques in the talented hands of Dr. Ilan Cohen can reduce the chance of most of these unpleasant outcomes if a corneal transplant becomes the final choice.

Alternatives to Corneal transplant:

A corneal Transplant may become necessary as the last option; however, we will do our best to avoid the need for corneal transplantation using less invasive Technology such as Intacs, DSEAK, and PRK. Please contact our office to arrange for a consultation.

We, the doctors and the staff of the 5th Avenue Eye Center, are committed to providing you with the best surgical solutions available anywhere in the world and have offices located in New York and New Jersey.

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