Transplant of outer layer of corneal tissue

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What is a corneal transplant?

The cornea is the most transparent part of the eye, and it covers the front portion of your eye. Its function is to collect light to enter your eye. 

A corneal transplant is a procedure used to replace the damaged part of your cornea and replace it with healthy corneal tissue from a donor. This procedure can help improve vision and minimize pain caused by any disease or damage to your cornea.

Why would I get this procedure?

Your doctor may recommend a corneal transplant in some conditions. These conditions are usually causing so much pain or impairment of vision. They include:

  • Keratoconus. It is one of the most common indications for a corneal transplant. This disease causes the cornea to weaken, causing it to bulge outward and change its shape.
  • Degenerative diseases. Such conditions cause corneal dysfunction, but slowly. Fuch’s dystrophy is an example. 
  • Corneal scarring
  • Corneal ulcers 

What happens during the procedure?

Before surgery, you will be given a sedative to help you relax and a local anesthetic to numb the eye. 

There are different procedures used to do a corneal transplant. They depend on whether you will remove the entire thickness or partial thickness of the damaged cornea. 

Full-thickness corneal transplant

If you are going to remove the entire thickness of the cornea, a procedure called penetrating keratoplasty (PK) is used.

Partial-thickness corneal transplant

This involves transplanting parts of the cornea, not the entire cornea. It is further subdivided into transplants that involve the front portion of the cornea and transplants that involve the back portion.

Transplants that involve the front portion of the cornea

  • Anterior lamellar keratoplasty
  • This procedure involves replacing only the front layer of your cornea. This would leave the deep healthy layers intact.
  • Deep anterior lamellar keratoplasty
  • Here, the outer, as well as the middle layers, are removed. This would leave the back of the cornea intact.

Transplants that involve the back of the cornea

  • Descemet’s membrane endothelial keratoplasty
  • This procedure involves replacing only the inner cell layer of the cornea. 
  • Descemet’s stripping endothelial keratoplasty
  • This procedure involves removing the inner lining of your cornea as well as around 20% of the corneal supporting tissue (corneal stroma)

What happens after the procedure?

If you had a partial-thickness transplant, most likely, you would be able to go home the same day as your surgery. But if you had a full-thickness transplant, you may need to stay for a night.

After the procedure, you might find your vision to be a little bit blurred; this is normal. Some pain and discomfort are expected after the surgery as well, but they can be controlled with pain medications.

You should also wear some kind of eye protection (glasses or eye shields) to protect your eye from getting any infection.

Conclusion

A corneal transplant will help restore your vision and decrease your eye symptoms. You should consider frequent follow-up exams to help your doctor monitor your eye and catch any complications like corneal rejection. Your follow-up appointments will gradually become less frequent with time. 

Citations

Mayo Clinic: Cornea transplant

Nhs. uk: Cornea transplant

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