Corneal Transplant (Artificial & Conventional)

What is a corneal transplant?

A corneal transplant, or keratoplasty, is a surgical procedure that replaces a cloudy or scarred cornea with a clear donor cornea to improve vision.

When the cornea becomes cloudy due to disease or injury, light rays are unable to pass through to reach the retina (the light-sensitive part of the eye). This can lead to poor vision or blindness. The cornea can be damaged by:

  • Corneal injuries
  • Infections or diseases
  • Age-related degeneration

Types of corneal transplant surgery

In general, corneal transplant surgery can be classified into:

  • Descemet's Stripping Endothelial Keratoplasty (DSEK). A procedure that removes diseased endothelial cells from the inside of the cornea and replaces them with a new layer of endothelial cells.
  • Lamellar keratoplasty. A more advanced procedure that replaces diseased parts of the cornea and does not affect healthy corneal tissue. It is also known as a partial corneal transplant.
  • Penetrating keratoplasty. Generally regarded as conventional corneal transplant surgery, this procedure replaces the entire cornea.
  • Artificial cornea transplant (keratoprosthesis). This procedure replaces a diseased or scarred cornea with an artificial cornea made of plastic polymers.

Your surgeon will advise the most suitable procedure based on your condition and clinical findings.

Donor corneas

In Singapore, donor corneas are procured:

  • Locally through cornea donation programmes (e.g. by the Singapore Eye Bank)
  • Internationally from accredited eye banks (e.g. from countries such as Sri Lanka, the United States and the Philippines)

Why do you need a corneal transplant?

If you have poor vision due to a diseased or cloudy cornea but have a healthy nerve and retina at the back of your eye, a corneal transplant can help to restore your vision.

As the damaged cornea can look cloudy, replacement with a clear donor cornea can also be a cosmetic improvement.

A corneal transplant can treat conditions such as:

  • Swelling of the cornea
  • Thinning or rupture of the cornea
  • Fuchs' dystrophy, a hereditary condition
  • A cornea that bulges outward (keratoconus)
  • Cornea scarring, caused by infection or injury
  • Corneal ulcers not responding to medical treatment
  • Complications caused by previous eye surgery

What are the risks and complications of a corneal transplant?

A corneal transplant is relatively safe. However, it carries a small risk of complications, such as:

  • Bleeding
  • Eye infection
  • Pressure increase within the eyeball (glaucoma)
  • Problems with the stitches used to secure the donor cornea
  • Retinal problems, such as retinal detachment or swelling
  • Rejection of the donor cornea

Symptoms of corneal transplant rejection

Cornea rejection – when your immune system attacks the donor cornea – occurs in about 10% of cornea transplants. Visit your ophthalmologist immediately if you experience:

  • Light sensitivity
  • Eye pain and reddening
  • Vision loss or impairment
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