Corneal transplantation

Of all the Canadians currently waiting to receive corneal transplants, only a small percentage of them will get the help they need to restore their sight. You can change that by arranging to become an eye donor.

When you donate your eyes, you are primarily donating the cornea, the thin layer of tissue that covers the eye like a window. The cornea focuses light ray on the retina and protects delicate working parts of the eye from injury. Replacing a scarred or damaged cornea is like replacing a frosted window with a clear glass.

Anyone can be an eye donor. Because the cornea is a clear layer of tissue, it is not necessary to match the eye colour, age or sex of the donor. Even if you wear glasses or have other eye conditions such as cataracts, you may still have healthy corneal tissue suitable for donation.

All donors are checked for AIDS, hepatitis and a host of other diseases and all tissue is checked for clarity before the transplant proceeds. Corneal transplants are by far the most successful transplants performed today – a remarkable 85% of people who receive new corneas regain their sight.

People who may benefit from a corneal transplant include those who:

• have experienced corneal failure after eye surgery;
• have conditions such as keratoconus, a steep curvature of the cornea;
• have hereditary corneal failure; those who have scarring after an eye injury;
• have scarring after having infections such as herpes; or
• have rejected a cornea after the first transplant.

To give the gift of sight, simply fill out any donor consent card such as the one that comes with your drivers license. Then, keep the card with you.

Recording your gift in a will is not enough. By time the will is read, it will be far too late to use the cornea. If you are over 18 years of age, you do not need approval from next-of-kin. You should discuss it with them, however, as they may be able to help ensure your wishes are carried out.

Corneal transplants are the most successful kind of transplant performed today, but those in need depend on you to give the gift of sight. To find out more, please contact the Eye Bank office near you.

Once you and your ophthalmologist have decided that a corneal transplant is right for you, your name is put on a list at the nearest eye bank. When tissue becomes available and has been checked to ensure its suitability, the surgeon is contacted and arrangements are made. Most transplants are performed within hours of the tissue becoming available.

The surgery itself is painless and usually done on an outpatient basis. First, you are given eye drops or medication to help you relax. Then, a local or general anesthetic is used to prepare the eye. Using a surgical microscope, the ophthalmologist measures the eye to determine the size of the corneal transplant. The diseased or injured cornea is then carefully removed and a clear donor cornea is sewn into place. A patch is usually worn over the eye immediately following surgery.

First-time corneal transplants are sometimes rejected. Procedures can be repeated, usually with good success, although the rejection rate is higher. The rejected cornea clouds and vision deteriorates. If treated promptly, most rejections can be stopped with minimal injury. Signs of rejection include persistent discomfort, light sensitivity, redness and change in vision.

Other possible complications include infection, bleeding, swelling or detachment of the retina or glaucoma all of which can be treated.