Corneal Surgery Procedure

Dr Connell performs a full pre-operative assessment to establish the objective severity of the corneal condition and the impact it is having on the patient’s day to day functioning. These factors are considered when guiding the patient on whether to proceed with surgery.

Once the patient makes the decision to proceed with a corneal transplant, plans are made regarding a date for surgery which does need to consider when a donated cornea is likely to be available. We are fortunate in Melbourne that donated corneas can be kept for up to 4 weeks from the date of donation, ensuring a relatively constant supply, making cancellation around the time of surgery due to donor unavailability a very rare event.  Unlike other types of transplantation, the donated cornea does not need to be genetically matched to the recipient.

Corneal surgery is typically done under local anaesthetic, administered by an anaesthetist.  Only the eye is put to sleep and the patient is sedated to make them feel relaxed.  The eye feels numb however there is no pain, the only feeling is the surgeon’s hands resting on the forehead.

Some patients are anxious they will see what is happening.  Typically, patients report seeing movement of shapes and shadows but nothing that allows them to know what is happening.  Following the procedure, a patch is placed over the eye, the patient is taken into the recovery room and given something to each and drink. For patients having an endothelial keratoplasty they are required to lie flat as much as possible overnight till the following morning to promote adherence of the graft.

The patch is removed the next day and need not be worn again.  At this stage the vision is blurred, the speed of vision recovery varies from patient to patient.  The eye will typically feel scratchy and sandy, which gradually improves over time.

The timing of return to work and normal activities such as driving depends on the type of procedure, vision in the other eye and speed of recovery. Once able to recommence driving, it should be done gradually, wearing sunglasses, driving short distances locally and building this up gradually.  Antibiotic and prednisolone steroid drop need to be administered at least 4 times per day for the first month, beyond this the antibiotic is stopped and prednisolone drop frequency gradually reduced.  This would typically be stopped at 2 years although if there are risk factors for rejection the duration longer.