Eye specialist Mr James Ball on the questions to ask 

We asked James Ball, consultant ophthalmic surgeon at St James's University Hospital Leeds, what he would want to know about corneal transplantation.

How common are corneal transplant operations?
In 2006 more than 2,500 corneal transplants were performed in the UK.

What should I ask the surgeon?
It’s a good idea to find out how many corneal transplants the surgeon performs a year. In an ideal situation, it should be 25 or more.

Are corneal transplants the same for all patients?
Fifteen years ago, all corneal transplants were 'full thickness' transplants. Today, due to advances in technique and knowledge, a corneal transplant has become tissue-specific for most patients. This means that only the diseased part of the cornea is replaced, and the patient keeps as much of their own cornea as possible.

Will I have to wait a long time before I have an operation?
There isn’t always a ready supply of corneas in the right condition. This can result in a delay before surgery can be performed. This is why it's important that as many people as possible register as organ donors.

Will I have much warning before my corneal transplant?
Patients often have as much as four weeks notice before their operation is carried out. Once a cornea has been harvested from a donor, it's sent to the National Eye Bank for three to four weeks where it's rigorously tested to ensure that it's healthy and suitable for transplant.

Is there a difference between a corneal transplant for older and younger patients?
No. However, the eye bank tries to match the donor corneas according to age so that younger patients receive transplants from younger donors.

Patients from different age groups tend to need corneal transplants for different reasons. The most common reason for a young person to need a corneal transplant is a condition called keratoconus. The most common reason for an elderly patient to need a corneal transplant is endothelial failure. Both of these conditions can be treated with a full thickness corneal transplant (penetrating keratoplasty).

However, many corneal surgeons would now treat keratoconus with a lamellar transplant (DALK) – a partial thickness cornea transplant, and endothelial failure with endothelial replacement (DSEK) – a new partial thickness procedure in which only the lining of the cornea is replaced.

What are the risks of corneal transplant?

  • With any eye surgery there's a small risk of infection inside the eye – although this occurs in less than 1 in 1,000 patients. If infection inside the eye does occur, there's a risk of losing all of the sight in that eye.
  • Rejection of the donor tissue is also a risk, but this is relatively common. As long as it's caught in time, it can be stopped.

How often will I have to have a check-up following the transplant?
Follow-up after a full thickness transplant is a big commitment. After surgery, a patient needs to return for at least six follow-up visits each year for the first two years. They must be aware that there's a lifelong risk of corneal transplant rejection. Eye drops reduce the risk of infection and rejection. They have to be applied daily for at least six to nine months and possibly longer.

'It's important that as many people as possible register as organ donors' 

Page last reviewed: 20/03/2015

Next review due: 20/03/2017