The cornea is the transparent, dome-shaped surface of your eye that accounts for a large part of your eye's focusing ability. A cornea transplant is a surgical procedure to replace (stitch in) a damaged or diseased cornea, with corneal tissue from a deceased donor.
Cornea transplant is the most common transplant operation performed in the United States and is typically performed as an outpatient procedure. Also called keratoplasty, a cornea transplant can restore vision, reduce pain and improve the appearance of a damaged or diseased cornea. Cornea transplants are most often used to restore vision to a person who has a damaged cornea. It may also relieve pain or other signs and symptoms associated with diseases of the cornea.
Most people who receive a cornea transplant will have their vision at least partially restored. The risk for complications and cornea rejections continues for years after a cornea transplant. Also, vision may initially be worse than before your surgery as your eye adjusts to the new cornea. It may take several months for your vision to improve.
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Eye surgery without stitches
Every year about 40,000 Americans go through corneal transplant surgery to clear their vision. Now a different technique can restore vision faster.
 
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Fuchs' dystrophy is a slowly progressing disease that usually affects both eyes occurs when endothelial cells gradually deteriorate without any apparent reason. The short-term success rate of corneal transplantation is quite good for people with Fuchs' dystrophy.
A corneal transplant can treat the corneal swelling for a patient suffering from iridocorneal endothelial (ICE) syndrome. Keratoconus, a progressive thinning of the cornea, is the most common corneal dystrophy in the U.S., and can also be treated with a corneal transplant. As patients with lattice dystrophy age, a corneal transplant may help ease obscured vision.
Descemet Stripping Endothelial Keratoplasty or DSEK, is a new procedure for patients with corneal edema who require a corneal transplant. DSEK works for patients whose corneas begin to cloud over due to endothelial dysfunction. This surgery cannot be performed on a scarred cornea or an irregularly shaped cornea. Using this technique, doctors replace just the damaged inner layer of the cells with an incision small enough that is does not require stitches.
The DSEK procedure involves the removal of the diseased inner layer of the cornea, or endothelium, and its underlying membrane. This is then replaced with the healthy inner layer of the cornea from a donor. This usually results in more rapid visual rehabilitation for the patient and also reduces the risk of complications that would affect their sight. In addition, the eye is much stronger and more resistant to injury since only the diseased tissue, rather than the entire cornea, is replaced, with less chance of rejection.
Compared to a corneal transplant, DSEK carries few risks. However, the posterior graft can dislocate, when the circular disc clips slips from its intended position, and may need to be repositioned or replaced in the operating room. In some cases, a standard corneal transplant may need to be performed. There is also a risk of rejection, when the body's immune system starts to fight against the cornea. The symptoms of rejection include redness, blurry vision and light sensitivity; this can happen months even years after the transplant.
