Corneal Transplant (Partial Thickness): Before Your Surgery

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Anatomy of the eye

What is a partial thickness corneal transplant?

A partial thickness corneal transplant (called DSAEK, DMEK, or DALK) is done to remove the diseased, infected, or scarred part of the cornea. That part is replaced with healthy corneal tissue from a person who has died. The cornea is the clear surface that covers the front of the eye.

In most cases, you will be awake during the surgery. The doctor will put medicine in your eye to numb the area. You may also get medicine to help you relax. Or you may get it to make you sleep during the surgery.

Surgical tools are used to keep your eye open. You may feel some pressure in your eye. The doctor makes a small cut (incision) in your cornea. Then he or she removes the unhealthy part of your cornea. Next, the doctor places healthy tissue inside your eye. An air bubble is used to hold the new tissue in place.

The transplant takes about 1 hour. Most people go home on the day of the surgery. But the air bubble stays in place for about 48 hours. You may be told to lie on your back at times throughout the first few days. You may also need to sleep on your back.

After the surgery, you will also need to wear an eye shield overnight. Then you will need to wear a clear eye shield or glasses to protect your eye. You'll use this until the eye has healed.

Ask your doctor when you will be able to return to work and your normal routine.

How do you prepare for surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
  • Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
  • If you have an advance directive, let your doctor know. It may include a living will and a durable power of attorney for health care. Bring a copy to the hospital. If you don't have one, you may want to prepare one. It lets your doctor and loved ones know your health care wishes. Doctors advise that everyone prepare these papers before any type of surgery or procedure.

What happens on the day of surgery?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Your surgery may be canceled if you have an eye infection, your eye is swollen, or there are problems with the donor cornea.
  • Follow your doctor's instructions about when to bathe or shower before your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

  • Bring a picture ID.
  • The area for surgery is often marked to make sure there are no errors.
  • You will be kept comfortable and safe by your anesthesia provider. You may get medicine that relaxes you or puts you in a light sleep. The area being worked on will be numb.
  • The surgery takes about 1 hour.

When should you call your doctor?

  • You have questions or concerns.
  • You don't understand how to prepare for your surgery.
  • You become ill before the surgery (such as fever, flu, or a cold).
  • You need to reschedule or have changed your mind about having the surgery.

Where can you learn more?

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The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.