The cornea is the clear, outer layer of the eye. A corneal transplant is usually recommended when vision due to cornea changes can no longer be improved with medical treatment or corrective lenses. Eye diseases and conditions that may necessitate a corneal transplant include keratoconus, Fuch’s dystrophy, ocular herpes infections, chemical burns and trauma. Also, since the corneal contains nerve endings, a transplant may be necessary to alleviate extreme pain caused by trauma or disease.

A corneal transplant, which is also known as penetrating keratoplasty (PKP), is a surgical procedure in which a damaged cornea is replaced by a donor cornea from an eye bank. During the operation, a round portion of the damaged cornea is removed and replaced with a round portion of the donor cornea. The donor cornea is sutured into place with very thin nylon thread. These sutures will remain in place several months during the healing process. Antibiotic drops and steroid drops are used post-operatively and long-term use of steroid drops may be necessary to prevent rejection of the new corneal tissue. Since the cornea normally does not contain blood vessels, the rejection rate of the donor cornea is very low, between 5% and 30%, compared to other transplant surgeries. However, a corneal transplant will require dozens of follow-up visits with your surgeon, the healing process is quite lengthy, and post-operative vision is rarely regarded as perfect.

Over 40,000 cornea transplants are performed in the United States each year, making it the most common and successful transplant procedure performed today.

There are currently an estimated 45,000 Americans waiting for cornea transplants, and only 50,000 transplants are performed annually, so many patients wait over a year for needed tissue.

In addition to corneal tissue, other tissue around the eye can be also used in reconstructive surgery, and researchers are continually working to expand the use of donated eye tissue.

There is a severe need for increased donor and tissue donation in the U.S., but misconceptions prevent many people from becoming donors. In order to be a donor, you must sign a donor card or the back of your driver’s license, and you must inform your family of your wishes since the next of kin must give consent for donation in Nebraska. Most religions do endorse organ and tissue donation, and the donation will not delay funeral arrangements or prevent an open casket funeral. Donors range in age from newborns to 70, but all willing donors are evaluated for medical suitability. Currently only a third of all potential candidates in the U.S. actually become donors.