Consultant Ophthalmologist,
Cataract & Refractive Surgeon

BMedSci BM BS MRCS MRCSEd MRCOpth FRCOphth MMedLaw PgD Cataract & Refractive Surgery

Corneal Grafting

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Pathology that compromises the cornea's clarity or integrity may be treated by a corneal graft, also called a penetrating keratoplasty. Graft material comes from a bank of donated tissue. The original cornea is cut away and the new cornea sutured in place. The sutures inevitably cause some irregularity and astigmatism. The sutures may have to be removed once the cornea has healed (usually after at least a year), or other procedures may be required to minimise the astigmatism. Topical steroids are usually given for an extended period.

Complications

Rejection

Graft rejection is a significant concern months or even decades after the procedure. An eye with a corneal graft that becomes red should be assessed very quickly by the ophthalmology department. Early intervention with intensive topical or even systemic steroids may reverse the rejection and save the cornea.

Loose sutures

The many sutures holding the graft in place are prone to loosen over time. They will give a foreign body sensation but, more worryingly, may cause rejection or infection of the graft. They should be removed immediately by the hospital eye service. If this occurs in the early postoperative period, the stitches may need replacing.