Corneal transplantation is the only way for patients blinded by keratoconus to regain their sight. With the continuous advancement in corneal transplantation techniques and equipment, corneal transplantation has brought sight back to a large number of patients with corneal blindness. Let’s learn more about what blinding keratoconus and corneal transplantation are. 1. What are the blinding keratoconus? There are many different types of blinding keratoconus. They include: conical cornea, corneal dystrophy, corneal white spots left after healing of keratitis or corneal ulcers, traumatic corneal scar, large vesicular keratopathy, various corneal ulcers that cannot be controlled by medications, chemical and thermal burns of the eye, and many other diseases. 2.What is corneal transplantation? Corneal transplantation is the only way to improve the vision of patients who are blind from keratoconus. Simply put, a corneal transplant is the use of a donor’s clear cornea to replace a patient’s cloudy, diseased cornea for the purpose of improving vision and treating keratoconus. Corneal transplants can be divided into penetrating corneal transplants and lamellar corneal transplants by surgical procedure. Penetrating corneal transplants are suitable for patients with lesions involving the whole cornea, while lamellar corneal transplants are suitable for patients with corneal lesions not involving the whole cornea. The photos shown below are before and after corneal transplantation. 3.Does corneal transplantation reject? As a tissue transplant, corneal transplantation does carry a risk of rejection due to the use of cornea from another person. However, the cornea itself has no blood vessels, so corneal transplantation is currently the most successful transplantation procedure, such as cone cornea, corneal dystrophy and other diseases after corneal transplantation more than 90% will not occur rejection. However, for patients with vascular keratoconus, especially patients with thermal and chemical eye injuries with vascularized ocular surface, are at high risk of corneal transplantation, the incidence of rejection after surgery is higher, to strengthen the application of local and systemic immunosuppressants. 4.Do I need long-term medication after corneal transplantation? To prevent the occurrence of rejection, immunosuppressive drugs will be routinely used after corneal transplantation, including topical drugs such as hormones, cyclosporine, FK506 drops, etc. For high-risk patients, oral immunosuppressive drugs such as cyclosporine are also required. The incidence of rejection is higher from 1 month to 6 months after corneal transplantation, so patients should follow up regularly during this period according to the doctor’s requirements and adhere to the medication. After six months, the incidence of rejection may be significantly reduced, and the number of medications can be gradually reduced until they are discontinued according to the doctor’s requirements. Patients after corneal transplantation should remember to follow the doctor’s requirements for medication and regular follow-up visits, and not to stop medication on their own. 5.When will the stitches be removed after corneal transplantation? Corneal transplantation stitches can be removed about one year after surgery. However, in some special cases, such as loose sutures, infection, and new blood vessel growth, the sutures can be removed earlier to reduce eye irritation and inflammation, and to reduce the occurrence of rejection. However, the sutures after corneal transplantation are not necessarily removed at one year. If the vision is good after surgery and the sutures are not loose or other related problems, there is no urgency to remove them. In addition, children’s corneal transplants are different from adults in that the removal of stitches is usually done within 1-4 months after the surgery. 6. What are the possible complications that can occur after corneal transplantation surgery? Corneal transplantation is the most successful transplant available, but there are possible complications that can occur with any surgery. Complications are not terrible, and most of them can be cured by proper recognition of these possible problems and timely and appropriate treatment. The following are the main complications that may occur after corneal transplantation: (1) corneal transplantation discharge reaction: the patient suddenly feels red eyes, pain, blurred vision, then the first thing to think of possible rejection reaction, you can first use hormone drops, cyclosporine drops eye treatment, and come to the hospital as soon as possible to follow up, find the surgeon for timely treatment, if timely treatment of most of the rejection reaction is Most of the rejection can be treated. (2) High intraocular pressure after corneal transplantation: Early after surgery, high intraocular pressure can occur due to tissue edema and inflammatory reaction, resulting in eye swelling, eye pain and even headache. Therefore, it is necessary to closely observe the IOP after surgery and treat the problem with IOP-lowering drugs in a timely manner once it is detected, otherwise high IOP can compress the optic nerve of the eye and lead to blindness. In addition, the hormonal eye drops used for anti-inflammatory and anti-rejection reactions after surgery can also lead to hormonal glaucoma, so the IOP must be measured regularly after corneal transplantation, at least once every 2 weeks, or if it is inconvenient to come to our hospital, it can be measured at the local hospital. (3) Recurrence of corneal primary disease: Some corneal diseases may still recur after corneal transplantation, such as viral keratitis, fungal keratitis and other diseases. Once the situation is found, you should seek medical treatment for the original disease in time, so as to prevent the failure of corneal transplantation due to the recurrence of the original disease. (4) Astigmatism after corneal transplantation: due to various reasons such as loose or tight surgical sutures and wound alignment, patients will have different degrees of astigmatism after corneal transplantation, which will affect their vision, and suture adjustment or lens adjustment can be performed later. (5) Corneal wound cracking: The cornea cannot withstand excessive force after corneal transplantation surgery, such as accidentally touching the eye, coughing violently, or even lifting heavy objects will lead to corneal wound cracking, once it happens, you need to rush to our hospital for necessary repair treatment. (6) Loose sutures: Loose sutures after corneal transplantation can cause foreign body sensation in the eye, eye redness and increased secretion. In these cases, you should visit the hospital and remove the loose sutures to avoid complications such as infection and rejection. After removal, the doctor will decide whether the sutures need to be re-sewn according to the situation. 7.What issues should I pay attention to before and after corneal transplantation? If you have cough or asthma before the corneal transplantation surgery, you should inform the doctor in advance. During the surgery, the patient should keep his head still and should not hold his breath or cough. In the early post-operative period, patients should wear eye shields to avoid eye bruising, do not cough violently, and keep bowel movements smooth. There is no special contraindication to the post-operative diet, avoid spicy and stimulating food, smoking and alcohol; it is advisable to be light, eat more soft and easily digestible food, eat more fruits and vegetables; keep the bowel movement smooth, get enough sleep and keep an optimistic and relaxed state of mind to facilitate the recovery after surgery.