What is corneal transplant (partial thickness)?

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Corneal transplant (partial thickness): Overview

A partial thickness corneal transplant (called DSAEK, DMEK, or DALK) is done to remove the diseased, infected, or scarred part of the cornea. That part is replaced with healthy corneal tissue from a person who has died. The cornea is the clear surface that covers the front of the eye.

In most cases, you will be awake during the surgery. The doctor will put medicine in your eye to numb the area. You may also get medicine to help you relax. Or you may get it to make you sleep during the surgery.

Surgical tools are used to keep your eye open. You may feel some pressure in your eye. The doctor makes a small cut (incision) in your cornea. Then he or she removes the unhealthy part of your cornea. Next, the doctor places healthy tissue inside your eye. An air bubble is used to hold the new tissue in place.

The transplant takes about 1 hour. Most people go home on the day of the surgery. But the air bubble stays in place for about 48 hours. You may be told to lie on your back at times throughout the first few days. You may also need to sleep on your back.

After the surgery, you will also need to wear an eye shield overnight. Then you will need to wear a clear eye shield or glasses to protect your eye. You'll use this until the eye has healed.

Ask your doctor when you will be able to return to work and your normal routine.

How can you care for yourself at home after a corneal transplant (partial thickness)?

Activity

  • Ask your doctor when it is okay to drive.
  • Wear your eye shield for as long as your doctor recommends.
  • You can shower or wash your hair the day after surgery. Keep water, soap, shampoo, hair spray or hair dyes, and shaving lotion out of your eye.
  • Do not rub or put pressure on your eye.
  • Do not wear eye makeup until your doctor says it's okay. You may also want to avoid face cream or lotion.
  • Avoid heavy lifting for about 4 weeks, or until your doctor says it is okay.
  • Avoid swimming, hot tubs, gardening, and dusting for 2 to 4 weeks.

Medicines

  • Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
  • If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
  • Follow your doctor's instructions for when to use your eyedrops. Always wash your hands before you put drops in. To put in eyedrops:
    • Tilt your head back, and pull your lower eyelid down with one finger.
    • Drop or squirt the medicine inside the lower lid.
    • Close your eye for 30 to 60 seconds to let the drops or ointment move around.
    • Do not touch the ointment or dropper tip to your eyelashes or any other surface.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.

How do you prepare for a partial thickness corneal transplant?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
  • Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
  • If you have an advance directive, let your doctor know. It may include a living will and a durable power of attorney for health care. Bring a copy to the hospital. If you don't have one, you may want to prepare one. It lets your doctor and loved ones know your health care wishes. Doctors advise that everyone prepare these papers before any type of surgery or procedure.

After corneal transplant (partial thickness): When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You have a sudden loss of vision.
  • You have sudden chest pain, are short of breath, or cough up blood.

Call your doctor now or seek immediate medical care if:

  • You have signs of an eye infection, such as:
    • Pus or thick discharge coming from the eye.
    • Redness or swelling around the eye.
    • A fever.
  • You have new or worse eye pain.
  • You have vision changes.
  • You have symptoms of a blood clot in your leg (called a deep vein thrombosis), such as:
    • Pain in the calf, back of the knee, thigh, or groin.
    • Redness and swelling in your leg or groin.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You do not get better as expected.

After a corneal transplant (partial thickness): Overview

You had a partial thickness corneal transplant (called DSAEK, DMEK, or DALK). It was done to remove a diseased, infected, or scarred part of the cornea. That part was replaced with healthy corneal tissue from a person who has died.

After your transplant, you may be told to lie on your back at times throughout the first few days. You may also need to sleep on your back. You will also need to wear an eye shield overnight. Then you will need to wear a clear eye shield or glasses to protect your eye until it has healed.

Your eye may feel irritated or scratchy for a few days after surgery. But it's important not to rub your eye. Rubbing your eye could damage it. Your vision may be blurry for a period of time after surgery. For some people, it may take 6 to 12 weeks to get the full benefits of surgery and to see as clearly as possible.

Your doctor will give you eyedrops to help your eye heal and prevent your body from rejecting the donor tissue. Use the drops exactly as directed. You will need to see your doctor often to have your vision checked.

You will probably be able to go back to work or your normal routine in about 1 to 2 weeks after surgery. But your vision will still be blurry. You will need to avoid heavy lifting for about 4 weeks, or until your doctor says it is okay.

What happens on the day of a partial thickness corneal transplant?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Your surgery may be canceled if you have an eye infection, your eye is swollen, or there are problems with the donor cornea.
  • Follow your doctor's instructions about when to bathe or shower before your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

  • Bring a picture ID.
  • The area for surgery is often marked to make sure there are no errors.
  • You will be kept comfortable and safe by your anesthesia provider. You may get medicine that relaxes you or puts you in a light sleep. The area being worked on will be numb.
  • The surgery takes about 1 hour.

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