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Corneal transplants are performed by ophthalmic surgeons who specialise in the treatment of diseases affecting the cornea, the front window of the eye.

Why would I need a corneal transplant?

Damage to the cornea that is so severe that a corneal transplant is required to restore vision can occur for several reasons:

  • Corneal infections due to bacteria, viruses, fungi or parasites can cause scars on the cornea that distort your vision. If this scarring is extensive and severe, a corneal transplant may be the only way to restore your sight.
  • Age-related conditions such as Fuchs' endothelial dystrophy can develop. This usually develops after the age of 50 and is caused by degeneration of the cells that support the cornea. As they deteriorate, the cornea swells and can blister, making the eyes red and painful.
  • Inherited conditions collectively known as corneal dystrophies can gradually cause cloudy deposits to accumulate in the normally clear cornea. As these become denser, eyesight can deteriorate.
  • One particular corneal dystrophy, keratoconus, is the most common reason why people under 30 need a corneal transplant. It has various causes, it can be inherited, and it leads to the cornea becoming misshapen. It thins and bulges, forming a conical shape, which in turn causes severe astigmatism that can make vision increasingly blurred.

For keratoconus and other conditions, a corneal transplant is not the first option for treatment. Other methods of management can help reduce the impact of scarring or changes in corneal shape, and are always tried first.

Types of corneal transplant

The London Clinic offers several different types of corneal transplantation techniques including all methods that involve lamellar or partial thickness keratoplasty. The lamellar techniques have the added advantage of faster visual recovery and a much lower risk of rejection.

The corneal transplant method used will depend on the underlying disease process:

  • Full thickness corneal transplant (penetrating keratoplasty): in this procedure, the entire cornea is replaced and this is done in cases where the disease process has involved the full thickness of the cornea.
  • Anterior lamellar keratoplasty: in this procedure, only the top layers of the cornea are replaced leaving behind unaffected healthy cornea. We prefer to use this technique in patients who have superficial corneal scarring or conditions such as keratoconus.
  • Posterior lamellar/endothelial keratoplasty: in this procedure, only the back layer of the cornea is replaced and this is typically performed in patients with Fuchs’ endothelial dystrophy who have damage to the back corneal layer only.

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