Corneal transplant surgery is a procedure that involves transplanting the cornea of the eye from a donor to a patient. This procedure is typically performed to address corneal issues that cannot be corrected with other treatments such as medications or glasses. While a successful corneal transplant surgery can improve vision, patients must also be aware of potential complications and problems that may arise after the surgery.
Graft Rejection
One of the most significant risks after corneal transplant surgery is the patient's body rejecting the transplanted cornea. Rejection occurs when the immune system recognizes the new tissue as foreign and attacks it. Rejection can cause the cornea to become swollen, or hazy or cause vision to blur, and the patient may experience pain or discomfort. In some cases, rejection can occur as soon as a few weeks after the surgery or as late as several years following the operation. Doctors carefully monitor signs of rejection, and if they are detected early enough, they can often reverse the rejection process using medications. Still, some patients may require another corneal transplant surgery.
Cataract Formation
Another potential complication is the formation of cataracts. A cataract is a clouding of the lens of the eye that leads to blurry vision. Some patients may develop cataracts following their corneal transplant surgery as the procedure can cause the proteins in the lens to clump together and form a cloudy region. Some cataracts may not require treatment, while others will require surgery to remove them and restore vision.
Glaucoma Development
Individuals who have experienced corneal transplant surgery also have a higher risk of developing glaucoma than individuals who have not undergone the procedure. Glaucoma is a condition that damages the optic nerve in the eye and can lead to vision loss. Doctors will monitor patients closely for signs of glaucoma through regular check-ups and additional testing to ensure early detection and treatment.
Case Report: Glaucoma with Corneal Transplant
Really interesting patient arrived at our office for a consultation. This patient had a corneal transplant secondary to a pseudomonas ulcer. She also has glaucoma, and she has a tube shunt about 5mm away from the limbus. She also has a fixed pupil. so her right eye is dilated permanently. She is also aphakic. She sees count fingers in that eye.
The main goal is to determine if her best potential vision can be improved as well as depth perception. With a diagnostic scleral lens, and over-refraction, she was able to achieve 20/50!
She has a very large corneal transplant. The tube shunt is far enough away from the limbus that I am going to design a lens with a smaller diameter to prevent it from interacting with the glaucoma surgery.
In the OCT image, you can see the tube with the blue arrow and the edge of the scleral lens with the yellow arrow.
Excited to see how she does with her new custom scleral lens.
Thank you to Dr. Stafeeva for your kind referral and great job to Dr. Saboori and Dr. Stafeeva for their beautiful work on this eye.
Specialty Contact Lenses
Following corneal transplant surgery, patients often require special contact lenses to help with vision correction. Specialty lenses, such as scleral lenses or rigid gas-permeable lenses, can help to address vision issues that arise from a corneal transplant. However, fitting for these lenses can be time-consuming and may require multiple visits to the eye doctor.
Blurry Vision
Even with proper care and follow-up appointments, some patients may still experience reduced vision following corneal transplant surgery. Blurry vision or other visual disturbances may result from changes in the cornea's shape or positioning after the surgery. These issues can often be treated through further surgeries or additional procedures.
Outcomes from Corneal Transplant Surgery
Complications such as the cornea being rejected, the development of cataracts or glaucoma, the need for special contact lenses, or reduced vision can occur. Any of these issues may require additional surgeries or procedures to correct. Patients should work with their eye doctor closely to monitor their conditions and address any complications that arise after their corneal transplant surgery. With proper care, patients can continue to enjoy improved vision and a better quality of life.
