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Corneal Transplant (Partial Thickness): Before Your Surgery

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. During this time, you will need to lie face up, looking at the ceiling. You'll lie this way except for when you need to eat or go to the washroom. After that, you will be able to move around again.

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.

You will probably be able to go back to work or your normal routine in about 1 to 2 weeks. But your vision will still be blurry. You will need to avoid heavy lifting for about 4 weeks, or until your doctor says it is okay.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

What happens before surgery?

Preparing for surgery

  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • Tell your doctors ALL the medicines and natural health products you take. Some of these can increase the risk of bleeding or interact with anesthesia.
  • If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if you should stop taking these medicines before your surgery. Make sure that you understand exactly what your doctor wants you to do.
  • Your doctor will tell you which medicines to take or stop before your surgery. You may need to stop taking certain medicines a week or more before surgery. So talk to your doctor as soon as you can.
  • If you have an advance care plan, let your doctor know. 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 suggest that everyone prepare these papers before any type of surgery or procedure.

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

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 cancelled. 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 cancelled if you have an eye infection, your eye is swollen, or there are problems with the donor cornea.
  • Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Take off all jewellery and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery centre

  • 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.

Going home

  • Be sure you have someone to drive you home. Anesthesia and pain medicine make it unsafe for you to drive.
  • You will be given more specific instructions about recovering from your surgery. They will cover things like diet, wound care, follow-up care, driving, and getting back to your normal routine.

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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