Hello, my name is Geoffrey Hill, MD. I am an ophthalmologist and cornea specialist, and I am excited to be the newest doctor joining the Hill Vision Services Team this summer. In this, my first blog post, I would like to begin by talking about the cornea, corneal surgery, and giving some general information about corneal transplantation.
Before talking about surgery, let us first clarify the question: What is the cornea?
Similar to the windshield of a car or the crystal on a wristwatch, the cornea is a clear structure that makes up the central, outer surface of the front of the eye. It forms a dome-like chamber over the iris (colored part of the eye), pupil (black, circular opening in the center of the iris), and lens – all of which are inside the eye. Just like a windshield, if the cornea becomes cloudy or opaque, it can significantly limit a patient’s vision.
What is a corneal transplant, and how is it performed?
Over the past 50 years, ophthalmologists have developed techniques to replace cloudy corneas and restore vision by performing corneal transplant surgeries. This type of surgery replaces the damaged cornea with clear corneal tissue from a human organ donor. In the past, corneal transplants were performed by removing a full-thickness, central, circular piece of the damaged cornea and sewing a replacement piece of donor tissue in its place. These kinds of grafts are called “penetrating keratoplasties” (or PKPs) because they involve replacing the entire thickness of the damaged cornea. To continue the wristwatch analogy, this would be like replacing the damaged or cracked crystal covering of your wristwatch with a clear new piece of crystal.
Is having a corneal transplant similar to having a liver or kidney transplant?
In some ways, yes. It is similar, although having a corneal transplant does not require taking the same lifelong regimen of medications as after a solid organ transplant. The transplanted corneal tissue comes from a human donor who has undergone very strict testing to make sure they are disease-free. Keeping the graft healthy requires taking some medications – usually only eye drops – to help decrease inflammation and to prevent the immune system from rejecting the transplanted tissue.
Cornea donation and the process of eye banking have a fascinating history and have allowed ophthalmologists to restore sight for millions of patients around the world. For readers who are interested in learning more, follow the link below to the Missouri Lions Club website:
In my next post, I will write more about some of the exciting new techniques for corneal transplants that we can offer, namely DMEK and DSAEK.