Corneal Transplants or Penetrating Keratoplasty

The cornea is a clear tissue on the surface of the eye that covers the iris (colored part of the eye).  Any disease or injury that results in clouding of the cornea or loss of corneal tissue may be an indication for corneal transplantation as a means to restore clear vision to the patient.  The most common infectious cause of a damaged cornea necessitating corneal transplant is herpes simplex keratitis.  Other patients may have inherited corneal diseases such as keratoconus and Fuchs’ dystrophy, which interfere with the functioning of the cornea.  Scars from injury are other reasons for surgery.
When Necessary?	The surgery involves removal of the patient’s damaged cornea in the operating room under local or general anesthetic with a trephine (a circular blade some compare to a ‘cookie cutter’).  See diagrams.  If other procedures need to be done such as cataract extraction or intraocular lens exchange, these are done before placing the new, (donor), cornea on the patient’s eye.  The donated corneal tissue is cut into a circular shape usually slightly larger than the opening left when the patient’s damaged cornea is removed.  It is then sewn into place on the eye with very small nylon sutures.  The surface layer (or epithelium) of the cornea will heal over the sutures so the patient doesn’t feel them after a few days to weeks.   It can take an average of one year for a corneal transplant to completely heal and reach the final vision (depending upon condition of eye and the age of patient).  Of course, to achieve excellent postoperative vision, the rest of the eye needs to be healthy and functioning well.  This means that other ocular diseases such as glaucoma, cataract, retinal detachment, or macular degeneration need to be recognized and treated (if possible).
1. White arrow shows opaque, damaged cornea. 2. Round shaped portion of damaged cornea removed. 3. A donor button of clear cornea is replaced. 4. The donor cornea is sutured into place.
The Results	Dr. Kent has over 17 years experience performing this surgery and very high success rates of improving vision.  She works closely with the patient before and after the surgery to be sure the patient is prepared and understands how to care for the eye postoperatively.  This is not a surgery to be undertaken lightly and the doctor-patient relationship is very important for a successful outcome.  Dr. Kent enjoys working closely with her patients and strives to make each patient feel cared for and satisfied with his/her results.