Cornea Transplant
Corneal Transplantation
The information contained in this form will help the success of the operation which you are going to undergo. You and the other members of your family should read this information and keep this form for future reference. If you have questions, do not hesitate to ask.
The cornea.
You are going to have an operation to fix a vital segment of your eye (Plan 1). The cornea is very similar to the glass of the watch. It is the transparent, round, protruding portion of the eye, visible when we look at the eye from the side. It is often referred to as the "window" of the eye. The cornea must remain clear in order to have good eyesight. Disease or trauma of cornea can lessen its clarity, resulting in loss of vision. We will discuss with you your case, the cause of the loss of your eyesight and the specific type of surgery we recommend.
CORNEAL GRAFT FROM THE EYE BANK FOR CORNEAL TRANSPLANTATION (PENETRATING KERATOPLASTY)
Currently, the only source of corneal tissue is receiving it from another human who has donated his corneas for transplantation or whose family has donated them after his death. It may seem disturbing to take graft from the deceased, but for most families the possibility to give eyesight to someone else acts as a relief. All corneas are tested for HIV, hepatitis viruses and other infectious diseases. When you make the decision that you will benefit from a transplant, you should communicate with the eye Bank to join the waiting list. Your surgery will be tentatively scheduled for a specific date in the hospital. Usually the graft is available on the scheduled day. Otherwise, there will be a new schedule soon after the original date.
BEFORE THE OPERATION
1. A blood sample will be taken
2. You will do an EKG and/or chest x-ray according to your age and your health status. These tests shall be made to ascertain that your health condition is stable for the surgery.
THE DAY OF THE SURGERY
1. Don't eat and drink anything after midnight.
2. When you come to the hospital take with you all your pills as well as their boxes. Let us know about any allergies that you might have.
3. Antibiotic eye drop instillation will follow as well as preparation for your eye surgery.
DURING THE OPERATION
1. If the anesthesia is topical:
a. the doctor will instill anesthetic around the eye so you do not move your eye temporarily. This will limit the vision of your eye during the operation.
b. Sterile cloths will be placed around your face while at the same time we will make sure that you breathe normally.
c. tell your doctor or nurse if you feel pain or discomfort during the operation.
2. If the anesthesia is General:
a. you will wake up on resuscitation room.
b. you will go back to your room after staying in the resuscitation room for a short time.
3. To ensure that the graft remains in place, very thin seams called sutures are placed around the peripheral part of your cornea, using a microscope (down Draft).
4. An ocular bandage and a protective cover will be placed on the operated eye following the end of the operation.
AFTER THE OPERATION
1. You will need to stay in the hospital for a few hours after surgery. You will be able to go to the toilet with the help of nurses and you will be able to stay seated during the meal. The upper part of the bed can be raised and you will be able to turn to the side of the non-operated eye.
2. If you have local anesthesia, you will be able to have your usual meal. If you have general anesthesia, liquids will be given to you as your first meal. You can have your usual meal the next day.
3. The bandage will stay in place until the next morning of the operation. Please let us know if you can open your eye beneath the bandage.
4. After the doctor removes the bandage and the cover, your eye will be examined and you will be allowed to wear your glasses during the day and the cover at night. If you do not wear glasses, then you should wear the protective cover continuously. Do not rub or scratch your eye.
5. Pain after corneal transplantation is usually minimal. Let us know if you have sudden or acute pain. 6. Antibiotics, as well as steroid drops should be used to avoid infection and rejection of the graft.
INSTRUCTIONS FOR HOME
1. Antibiotic and cycloplegic drops will be used for a month. Steroid drops will be used up to one year. We will teach you and your family the proper instillation of drops.
2. It is extremely important to take every dose of your medication.
3. You can clean the area around your eye, but avoid rubbing your eye. If there is eye gum using a damp and clean cleaning cloth, clean carefully the eyelid one or two times a day. Avoid putting the cleaning cloth inside your eye and do not use the same part of the cleaning pad. Avoid pressing your eye.
4. During the next few weeks, you should avoid strenuous activity, because this could lead to an increase in pressure of your eye and stitches. If you need to cough or sneeze, you can do it with your mouth open. Do not lift weights and do not lean your head lower than your heart.
A. you can:
- Return to school.
- Return to work on the condition that it does not require strenuous activity or heavy lifting.
-Drive a car since the vision in the non-operated eye is 20/40 or better with correction.
- wash your body taking care not to get soap in your eye.
- wash your hair with your head tilted backwards. -do minor chores at home. - read, watch tv or sew until your eyes get tired.
B. You May Not:
-participate in sports until you are allowed.
- lift weights.
-Bend down with your head lower than your heart.
THE LIKELIHOOD OF REJECTION OF THE GRAFT
Most likely your transplant will be successful. If it fails, this will probably lay in the fact that your body recognizes the graft as foreign and tries to eliminate it. This will lead to graft opacification. The body tries to eliminate the graft in 20% of the cases. If the graft rejection is treated early, then in 90% of cases the condition is reversible with medication, the graft will remain clear and the transplant successful. In cases where the rejection is not treated promptly, the probability of failure is greatest. It is therefore extremely important to recognize the potential signs of rejection and report them to us as soon as possible.
IF ANY OF THE FOLLOWING 3 POINTS OF RISK PERSIST FOR MORE THAN 24 HOURS, CALL THE OFFICE TEL. 210-9320215.
A. REDUCTION OF VISION: THE MOST COMMON WAY IN WHICH A PATIENT PERCEIVES TIMELY A REJECTION EPISODE IS BY THE REDUCTION OF HIS VISUAL ACUITY. IN THE EARLY POSTOPERATIVE PERIOD, START TO CHECK YOUR VISION EVERY DAY BY DOING THE FOLLOWING:
1. SELECT AN OBJECT ON THE WALL (A PAINTING OR A PHOTOGRAPH)
2. COVER THE NON-OPERATED EYE AND WALK BACKWARDS UNTIL THE OBJECT'S BOUNDARIES BECOME BLURRED.
3. TO BE EXACT WITH THE MEASUREMENT OF YOUR EYESIGHT, NOTE HOW FAR YOU ARE FROM THE OBJECT.
4. BECAUSE YOUR VISION WILL IMPROVE, WALK BACK AND SPECIFY NEW DISTANCE FROM WHICH YOU CAN SEE THE OBJECT.
5. IF YOU CAN'T SEE THE OBJECT AS WELL AS THE PREVIOUS DAY, THEN YOUR EYESIGHT HAS LESSENED.
B. SEVERE PAIN-AFTER SURGERY: THERE MAY BE A SLIGHT DISCOMFORT AROUND YOUR EYE, WHICH WILL LEAVE IN THE FOLLOWING DAYS. IF YOUR EYE ANNOYS YOU MORE IN ANY WAY, THIS COULD BE A SIGN OF REJECTION.
C. INTENSE REDNESS: AFTER SURGERY THERE MAY BE SLIGHT REDNESS OR SWELLING. THIS WILL GRADUALLY BEGIN TO IMPROVE WITHIN A FEW DAYS. ON THE CONTRARY, IF THE EYE GETS MORE RED OR SWOLLEN PLEASE CALL US.
D. SEVERE PHOTOSENSITIVITY: AFTER SURGERY, YOUR EYE CAN BE PHOTOSENSITIVE. YOU WILL BE GIVEN DARK GLASSES TO WEAR. THE SENSITIVITY WILL DECREASE GRADUALLY OVER DAYS OR WEEKS. IF PHOTOSENSITIVITY WORSENS AFTER A PERIOD OF IMPROVEMENT PLEASE CALL US.
* FLU SHOTS: SOMETIMES THIS VACCINE MAY INCREASE THE RISK OF REJECTION. IF YOU INTEND TO MAKE FLU SHOTS BEFORE OR AFTER SURGERY, PLEASE LET US KNOW. SOMETIMES DROPS WILL BE GIVEN BEFORE HAVING THE VACCINE.
Several months will pass before the final visual results become known, so you will be prompted to visit the clinic often during the first year. It is extremely important to attend the scheduled visits to make sure that you are on the right track. Please bring your medications with you on your visits. The stitches will be removed gradually, from the very first months after surgery or all together after about a year. In some cases the stitches won't ever be removed. This will be discussed during the healing phase. Glasses will be prescribed when the graft stabilizes. If you have any questions please call the Office.
Eye drops or ointments instillation
DOSAGE: Always follow your doctor's instructions. Do not skip doses or use the medicine more often than the instructions given.
INSTRUCTIONS: 1. Keep the eye drops or the tube clean. Avoid contact of the orifice of the eye drops or tube with anything, especially with your hands or any part of your eye. 2. Store the medication at room temperature. Keep it in the refrigerator when necessary. 3. Use the drug only for the eye for which you have been given the prescription. 4. Do not share your medication with anyone. 5. Only use medicines that your doctor has prescribed. 6. Never use drops that have changed color. 7. Do not carry the medication from one container to another. 8. Keep the medication away from children. 9. Wait for 5 minutes before instilling the next drop. 10. When you use both drops and ointment, instill the drops first. (A family member can help) 1. Wash your hands thoroughly. 2. If the eye drops were in the refrigerator, warm them carefully while rubbing the palms. 3. Shake the bottle as directed. 4. Pull the lower eyelid downwards and carefully instill the drop.
Good Luck!