Corneal Graft Post Operative Advice

Types of corneal graft:

PKP – Penetrating Keratoplasty – Full thickness corneal graft.
DSEK – Descemet’s Stripping Automated Endothelial Keratoplasty – Partial thickness corneal graft.
DMEK – Descemet Membrane Endothelial Keratoplasty – Partial thickness graft.

What to expect on the day of your surgery:

• Increased watering of the eye (blood staining is normal).
• Your eye may ache, take over the counter painkillers if needed.
• Your eye may feel gritty/prickly, this may last for a few days.
• Double / blurred vision.
• Sensitivity to light (photophobia).

If you have had a partial thickness corneal graft (DSEK/DMEK) an air bubble will have been inserted into the eye to hold the cornea in place. You may be asked to posture:

Lie flat on your back, facing the ceiling for 20 minutes. Lie with a pillow under your shoulders with your chin pointing to the ceiling for 20 minutes (similar to the picture below).

You can sit up, go to the bathroom, eat for 20 minutes. Repeat this cycle immediately following surgery and for the next 2 days while you are awake.

Sleep lying on your back facing the ceiling as much as possible for the next 3 nights.

The air bubble will be absorbed after a few days.

The morning after your operation:

• Gently remove your eye shield (if one was used).
• Wash the eye shield with warm soapy water.
• Wash your hands.
• With sterile cotton wool, clean your eye with cool boiled water. Wipe from the nose outwards. If required, you may gently pull down your eyelid to do this.
• Instil your eye drops as prescribed. Drops will need to be administered for several months after surgery. These will help to prevent inflammation, infection and rejection.
• Wear the shield to sleep in, at night for the first few weeks.

You are advised:

• Do not rub, poke or apply pressure to the operated eye. Pressure may cause the wound to open and be prone to infection).
• Avoid strenuous exercise, gardening, heavy lifting for 6-8 weeks.
• Do not go swimming for 4 weeks (wear goggles to swim afterwards).
• Avoid contact sports until advised by consultant it is safe to do so. Upon resuming contact sports wear protective goggles.
• Do not wear eye make up for 4 weeks.
• Do not perm / colour your hair for 4 weeks.
• Avoid contact lens’ for at least 8 weeks, until your specialist advises you that you can resume wearing them.
• Do not drive until you are seen at your outpatient appointment and have been told by a professional it is safe to do so (follow DVLA guidelines).
• Do not return to work for 2-3weeks. If your job involves heavy manual labour, lifting, or an unclean environment expect to be off work for 3-4 months.
• Avoid smoky/dusty environments that can irritate the eye.
• Do not use handkerchiefs to wipe your eye. Use a clean tissue each time.
• Wear sunglasses if your eye is sensitive to light, glasses will also protect the eye from foreign bodies if you are out in windy weather.

You can:

• Wash your hair, but with head backwards.
• Shower/bathe as normal, avoid getting soap/shampoo in the eye.
• Do light housework and shopping.
• Read watch TV.

Contact us if:

• Your vision deteriorates.
• If you experience severe pain, not relieved by painkillers.
• If you develop a sticky green/yellow discharge from the eye.
• If you experience new floaters.
• If you injure your eye.

Going forward:

It will take time for your vision to improve after a corneal transplant. It may take a few weeks up to a year or more. In some cases, it may fluctuate between being better or worse before it settles down.

It is advised not to get any new spectacles until your eye has settled down.

Symptoms of rejection:

• Red eye
• Sensitivity to light
• Visual loss
• Pain

Contacts: