Corneal Transplant

What is a corneal transplant?

A corneal transplant is an operation to replace a cloudy or scarred cornea with a clear cornea from another person, called a donor. A donor is a person who gives his or her eyes, after dying, to help others such as your child.

Your child needs a corneal transplant if your child's cornea is cloudy

The cornea lets light into the eye so that you can see.

If your child's cornea is cloudy, it can affect how well your child sees. A cloudy cornea will make your child's eyesight blurry. The amount of blurriness depends on how cloudy your child's cornea is.

Your child may need a corneal transplant if the cornea is cloudy because of any of these problems:

  • an injury to the eye
  • a very bad eye infection
  • swelling of the cornea
  • a thin cornea
  • a cloudy cornea that your child was born with
  • a corneal transplant that did not work

A corneal transplant should be done early

Your child should have a corneal transplant early. Early treatment helps your child's eye grow and helps eyesight develop properly. The doctor will talk to you about the exact time that your child should have a corneal transplant.

Your child will probably go home on the same day as the operation

Your child will usually have the corneal transplant as an outpatient unless she is very young. That means your child will go home on the same day she has the operation.

Caring for the eye after the corneal transplant

After the corneal transplant, the doctor will put a patch over your child's eye. The patch will probably be protected with an eye shield, which is a piece of metal or hard plastic that covers the eye.

The doctor will take off the patch the next day when your child comes back to the hospital. The doctor takes the patch off so that he or she can look at your child's eye.

Your child should not touch or rub the eye.

The doctor or nurse will tell you how to look after your child's eye after the operation.

Your child will take medicine after the corneal transplant

The doctor or nurse will give your child medicine for the pain, if needed. Most children do not have much pain after a corneal transplant. The doctor will let you know what pain medicine you can use.

Your child will also need medicine to:

  • help the cornea heal
  • reduce swelling, redness, and pain
  • prevent infection

The doctor will order eye drops and eye ointment for your child. Eye ointment is a special thick gel. Your child may need to use these eye drops or eye ointments for several months.

How to give your child the medicine

Do not force your child's eyelid open when you give your child any of these medicines. Forcing the eyelid opens puts pressure on the new cornea.

Your child will see the doctor after the corneal transplant

The doctor will see your child the day after the corneal transplant. Your child will see the doctor every week after that or as often as your child needs to.

Your child will keep seeing the doctor, even after the cornea is healed. The doctor will check your child's eyesight for any changes and any sign of problems.

The doctor will take your child's stitches out at least a month after the operation

When your child's stitches can come out depends on how well the cornea is healing. Sometimes the doctor will take them out as early as one month after the operation.

The stitches that hold the new cornea in place are very small and are very hard to see. The doctor will take them out in the operating room. We will call you with the date and time when your child is to have these stitches taken out.

Corneal Transplant
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The new cornea is held in place by stitches. The stitches are very small and are very hard to see.

Watch for problem signs at home

Watch for these warning signs that your child's body is rejecting, or trying to get rid of, the new cornea or that the eye is infected. Call the doctor right away if you see any of these warning signs:

  • Your child has pain in the eye that will not go away with pain medicine.
  • Your child is bothered by light more than he or she usually is.
  • Your child's eye is red, especially around the cornea.
  • A sticky liquid is draining from the eye.
  • Your child's eye has blood in it. A small amount of blood on the eye patch or in the tears is normal.
  • Your child's eye is swollen.
  • Your child's eyesight becomes worse (if your child is old enough to tell you).

If your child's new cornea does not work and cannot be saved, your child might need another corneal transplant.

Your child will slowly be able to see better

Your child's eyesight will improve slowly. How well your child sees depends on how bad the eye was before the corneal transplant.

Other problems with your child's eye can limit how well your child sees. In most cases, the cornea stays clear and the eyesight is good.

The doctor will decide later if your child needs glasses or contact lenses

After the cornea heals and the stitches come out, the doctor will decide whether your child needs to wear glasses or contact lenses.

Your child's eyesight will change rapidly during the first few months after the corneal transplant. Your child's eyesight might continue to change for months or years after this operation.

Your child will be tested for other eye diseases

Your child will have many follow-up examinations. During these examinations, your child will be tested for glaucoma and for amblyopia.

  • Glaucoma is caused by too much fluid collecting inside the eyeball. It can damage the optic nerve, which carries information about what we see from the eye to the brain.
  • Amblyopia happens when one eye loses the ability to see clearly. This happens when that eye is not used very much when a child is young. Amblyopia is caused by any condition that causes one eye to be favoured. The favoured eye has normal vision.

The new cornea

The new cornea will not change the colour of your child's eyes because the cornea is clear. The corneal transplant will make the natural colour of your child's eye clearer.

The race, sex, and colour of the donor eye do not affect how the child sees after the corneal transplant.

For a corneal transplant, the donor tissue or blood type does not have to match that of the child.

Your child has little or no chance of getting a disease from a corneal transplant. All tissues from donors are tested for contagious or catching diseases, such as AIDS and hepatitis, which is a disease of the liver.

Key points

  • A corneal transplant is an operation to replace a cloudy cornea with a new one from a donor.
  • Your child will need take medicine after the operation to help with healing and to prevent rejection of the new cornea.
  • Call the doctor right away if you see signs that the eye is infected or your child's body is rejecting the new cornea.

Asim Ali, MD, FRCSC

11/6/2009

For more information or help

If you have an emergency or if you have any concerns, call your doctor or the eye doctor on call at 416-813-7500. Or go to the emergency department at The Hospital for Sick Children.





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