Corneal Transplantation - Frequently Asked Questions

Frequently Asked Questions

1. Which doctor should I consult for corneal transplantation?

You should consult an eye doctor (ophthalmologist). Transplantation is performed by an ophthalmologist who has been trained in corneal surgery.

2. I have undergone corneal transplantation. My eyes are red, watery and sensitive.

Yes, this is normal. This is a major procedure and some discomfort can be expected in the initial few weeks following the keratoplasty. Your doctor will prescribe medications to keep you as comfortable as possible till you recover.

3. What diet should I follow after keratoplasty?

There is no special dietary restriction after keratoplasty.

4. How long does it take for the eye to heal completely after corneal transplantation?

It takes 1-2 years for the eyes to heal after penetrating keratoplasty. Lamellar procedures take much less time.

5. I cannot go for frequent check-ups after the procedure. Is it ok?

No. The success of corneal transplantation mainly depends on frequent post-operative visits that can monitor the healing process and optimise medications accordingly. If you cannot go for regular check-ups as recommended by the doctor, you may have to re-think your decision to undergo the procedure. Similarly, when corneal transplantation is performed in the pediatric age group, the parents should be aware of this, and often children may have to be examined under sedation or anesthesia if uncooperative.

6. After keratoplasty, is there anything I should specifically make sure of when I go back for check-ups?

Yes. You should take your eye medications with you when you go for a check-up, and make sure you use your medications up to and including the day of your  check-up.

7. What if a person has both a corneal opacity and a cataract at the same time?

Corneal transplantation can be combined with cataract surgery, vitreous and retinal surgeries in the same sitting.

8. What are the symptoms of graft rejection?

If there is any increase in redness, pain or light sensitivity, visit your doctor immediately to rule out evidence of any rejection or infection.

9. Are there adequate number of corneas to cater to the corneal blind people in India as of now?

Around 200,000 corneas are required in India per year. However, only about 44,000 are collected, and less than half of these are suitable for transplantation. This means that only about 10% of the requirement is being met.

10. Apart from the various experiments described above (which will obviously take time), are there any other methods being adopted right now with the available resources to improve donor cornea procurement? 

Nine countries in the world export corneas to other countries that cannot meet their demand for corneal procurement. Of these, the United States and Sri Lanka account for 94 % of the world’s donor cornea export.

Apart from this active eye donation awareness programs are being conducted world-wide and nationwide, every year August 25th to September 8th is observed as National Eye Donation Fortnight; various activities are conducted to increase awareness of and to motivate for eye donation.

11. Can diseases be transmitted from the donor to the recipient by corneal transplantation?

Yes, the following diseases have proven to be transmitted by corneal transplantation -

• Rabies
• Hepatitis B
• Retinoblastoma
• Bacterial and fungal corneal infections
• Creutzfeldt-Jakob disease

Apart from these diseases, because of possible transmission, corneas from donors known to have the following diseases are also excluded from transplants -

• HIV
• Hepatitis C
• Syphilis
• Malignant tumors of the anterior segment of the eye
• Leukemias and lymphomas
• Septicaemia (infection in the blood)
• Infective endocarditis (infection in the heart)
• Subacute sclerosing panencephalitis
• Death due to unknown cause
• Unidentified neurological disease

12. It is possible that one’s HIV status is unknown at the time of death. How do you tackle this situation?

Blood is drawn from every donor (at the same time that the eyes are removed), and tested for HIV, hepatitis B, hepatitis C and syphilis, and such eyes are used only after confirming that these test results are negative.

13. If on testing, one of the above tests is positive, what do you do with the eyes, since they cannot be used for transplantation?

The eyes are used for research purposes.

14. How many recipients can benefit from one donor?

Up to 4 people can benefit from one donor. Since 2 eyes are obtained from every donor, if a penetrating keratoplasty is preformed, 2 patients can benefit. If lamellar keratoplasty is performed, each eye can be used for one anterior lamellar and one posterior lamellar procedure, so 4 patients can benefit.

15. What are the advantages of lamellar keratoplasty over penetrating keratoplasty?

Following lamellar keratoplasty there is a more rapid visual recovery, improved graft survival and lesser post-operative astigmatism.

16. Are there any special precautions to be followed prior to the arrival of the team that removes the eyes?

Yes. The fan should be put off. If there is an air-conditioner, this should be switched on. The eyes should be kept closed, and moist cotton should be placed on the eyes. Ice should not be used. The head may be elevated by about 6 inches to reduce the chance of bleeding during eye removal. If available, antibiotic eye drops may be instilled frequently to reduce the chances of infection

17. How much does it cost to donate eyes?

It is free. The family is not charged anything for eye retrieval. No reimbursement for donation is made to the family either.

18. Will the face appear disfigured after eye donation? How long does the procedure take?

No, there is no disfigurement. The empty socket will be filled in with an artificial eye and the eyelids stitched shut. The procedure takes just about 20-30 minutes.

19. Is there any age limit for eye donation?

No. Eyes can be retrieved from persons of all ages.

Advertisement

20. Are eyes removed from living people?

No. Very rarely, if one eye is lost due to a disease where the cornea is healthy, that eye may be removed and the cornea transplanted to the other eye. This is extremely rare.

21. If the deceased person has never indicated that he would like to donate his eyes in his lifetime, can the relatives consent to donation?

Yes, they can. In India, the eyes can be donated only with the consent of the relatives even if the deceased person had indicated to donate the eyes during his /her lifetime.

22. Whom should we contact to donate eyes in the event of the death of a family member?

You should contact your nearest eye bank. Alternately, you can contact the nearest hospital, who will then assist you in the process.

23. I have undergone cataract surgery. Can I donate my eyes after death?

Yes, you can. As long as the cornea is clear and the endothelium is healthy, the cornea can be used for transplantation. People who wear glasses, and even people who are blind due to retinal or optic nerve disorders can donate eyes as long as the cornea is healthy.

24. I am diabetic and hypertensive. Can I donate my eyes after death?

Yes you can.

25. I have pledged my eyes for donation. Is there anything else I should do?

Yes. Please inform your next of kin, so that they can make sure that your wishes are carried out. Also, always carry your donor card with you.