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Corneal Graft
Corneal Graft
The cornea is the window at the front of the eye. In the normal eye the cornea is transparent. Light is able to enter the eye through a clear cornea, pass through the clear lens and focus on the retina at the back of the eye. When a cornea is deformed or damaged, by injury or disease, it is no longer transparent and the path of light to the retina is becomes distorted. The picture that the retina passes to the brain is not clear and sight is distorted or patchy.

A corneal graft is an operation in which a part of the cornea is removed and replaced with a similar piece of cornea from a donor eye.?

A corneal graft may be required due to irregularity, scarring or water logging. When it cannot be helped by other treatments (eye drops, drugs, spectacles or contact lenses) a corneal graft may be performed to:
Improve sight
Alleviate pain
Repair a perforation (if the cornea has ruptured)
The operation takes about an hour, and patients will be under general anasthetic throughout.
After the operation the eye will be covered with an eye pad and protective plastic eye shield. As the anesthetic wears off some discomfort may be felt in and around the eye. If pain is felt, medicine for relief of pain or sickness should be requested. You may resume normal activities when you feel able to do so.

The day after the operation the eye pad is removed and the eyelids cleaned. Your sight will probably be blurred, may water and be uncomfortable in bright light.

The nurse and your ophthalmologist will examine your eye. Any necessary eye drops will be prescribed and you will be shown how to use them safely and correctly.
Patients may be discharged from follow-up after the stitches have been removed, usually 1-2 years after the operation. Stitches are removed during an outpatient clinic examination and you will not need to stay in hospital overnight. However, even after discharge you should be aware that rejection episodes can occur and require urgent treatment.

You will be given a protective plastic eye shield to wear when sleeping for about two weeks after the operation. You should avoid any risk of a direct blow on your operated eye. You may find that you are sensitive to light and a pair of plain dark glasses should help. Ask your ophthalmologist when you may return to work or pursue sports, especially swimming. It maybe necessary to use the prescribed eye drops for 6 months or more after the operation. It is essential that the eye drop treatment is continued exactly as instructed until the end of the course. This is very important because it helps prevent infection and rejection.
There is a danger of rejection of the transplant if the body's immune defence system recognises the donor cornea as foreign and tries to reject the "foreign body". It is very important to look out for signs that your corneal graft might be undergoing rejection. If you experience one or more of the following, see a doctor or go to your clinic immediately:
Decrease in sight
Redness of the eye

Rejections occur most often in the first year after the operation, following a change of treatment, after removal of stitches, or as a result of eye infection or injury. However, rejection can occur at any time after a corneal graft, even years later after your discharge from outpatients. It is therefore important to be aware of the danger signs.

Providing you attend for treatment promptly rejection reactions can usually be controlled. It is your responsibility to go to your nearest eye department whenever you feel there is a problem with your grafted eye - even many years after successful surgery.

Failure to obtain the correct treatment early can result in permanent loss of sight and the need for a repeat transplant which will carry a higher risk of failure than the first. If you experience any decrease in sight, pain or redness in the grafted eye, remember that this may represent a rejection and must be seen within 24 hours in an eye department.
Other complications following a Corneal Graft
Serious complications are uncommon following graft surgery. However, it is a major eye operation and, like all operations, may be accompanied by complications including hemorrhage (bleeding in the eye) and damage to other parts of the eye. The period after the operation can be complicated by infection, rejection, glaucoma, and cataract formation. Therefore, it is essential that you keep all follow-up appointments. If any symptoms suddenly develop you must attend as an emergency patient at an eye casualty department without delay.