Eye Transplant Surgery: How It Works, Complications and More

Eye transplant surgery encompasses a number of procedures, including ones to correct for cataracts, glaucoma, corneal defects, retinal detachments and eye tumors. Most procedures are outpatient, and you will recover from them fully in weeks. Most eye surgeries have a high rate of success.

About Eye Transplant Surgery

Eye surgery, or ocular surgery, is one of the most common procedures performed around the globe. It encompasses surgeries done on the eyes and surrounding areas.

The primary purpose of eye surgery is to better someone’s vision, and it is done by correcting defects that someone had from birth, those caused by disease or age, or those stemming from an accident or acute trauma, among others. 

Whole-eye transplantation (WET) is a procedure to replace diseased retinal ganglion cells and all of the optical system. It can also include replacing surrounding tissues, if blindness stemmed from injury or trauma.

Today, WET is more a concept and experiment than a reality. Eye surgeons have no treatments for someone with optic nerve atrophy or retinal ganglion cell loss, conditions often caused by end-stage glaucoma and other conditions. They are hopeful that WET is a viable option in the future

Researchers are encouraged about early success rates of facial transplants and also by the data of WET procedures on cold-blooded animals.

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Candidates for Eye Transplant Surgery

Anyone who struggles with vision or sight issues can be a candidate for eye transplant surgery, but the exact requirements depend on the kind of surgery that is needed. For some, like refractive surgery, one must be at least 18 years old unless there are extenuating circumstances.

Typically, though, you are a candidate for eye surgery if:

• It is the only option left to treat your eye condition.
• It is the best treatment for your eye problem.
• You have a tumor that must be removed.
• You have cataracts.
• You are dealing with the adverse effects of glaucoma.
• Your retina is damaged or detached.
• Your eye muscles do not function appropriately.

Corneal Transplant Surgery 

Corneal transplant surgery is necessary when your cornea cannot be healed or repaired. The procedure involves replacing part or the whole diseased cornea with a healthy one from a human donor. Human donors agree to donate their corneas after death to patients who need them. 

The cornea helps focus light into the eye and serves as a protective layer for the eye. Good vision depends on the cornea is clear, smooth, and healthy.

Conditions that Affect Surgery

Conditions that may affect a cornea include:

• Keratoconus: It is a condition where the cornea has a cone shape instead of the normal dome shape.
• Fuch’s dystrophy: It is a condition that affects the effective functioning of cells in the inner cornea layer. 
• Eye infections or injuries: Doctors will shy away from surgery if there is scarring on the cornea.
• A past cornea or eye surgery: A damaged cornea makes for a more complicated procedure.

Corneal surgery is an outpatient procedure that lasts between 30 minutes to two hours, depending on the extent of damage the ophthalmologist is treating. The surgeon could perform full thickness surgery (the entire cornea is replaced) or partial thickness (only affected sections of the cornea are replaced). 

Corneal Surgery Process

The procedure involves the doctor placing a couple of antibiotic eye drops in the eye. He will then administer general or local anesthesia around the eyes to make them numb and prevent you from feeling pain. 

Next, he will set up a device on your eyes to keep them open during the procedure. The doctor will then remove the affected part of the whole cornea and replace it with a matching one from the donor. He will then use small stitches to seal the eye. A shield is then placed over your eye to protect it through the recovery period. 

You will be ready to go home the same day or the day after, and the doctor will give you instructions for after-surgery care. You will also have regular hospital visits until the eye fully heals. 

Other Types of Eye Transplant Surgery 

Besides corneal surgery, other common types of eye surgery include:

• Refractive surgery
• Cataract surgery
• Glaucoma surgery
• Retina surgery
• Eye muscle surgery
• Macular degeneration surgery

Refractive Surgery

This type of surgery involves procedures for correcting errors that affect the refraction of light in the eye. Such errors include myopia (near-sightedness), hyperopia (farsightedness), astigmatism, and presbyopia. The procedures involve either implanting a lens inside your eye or correcting how your eyes refocus image by changing the shape of the cornea. 

Presently, the main refractive surgery methods are LASIK (laser-assisted in situ keratomileuses) and PRK (photorefractive keratectomy). They both use laser technology to reshape the cornea, with the difference being LASIK adjusts the cornea under the flap while PRK shapes the surface of the cornea. 

Cataract Surgery

A cataract is a cloudy spot that forms on your lens and eventually leaves you with blurry vision. A cataract surgery corrects this by removing the cloudy lens and replacing it with a clear artificial lens. It takes under an hour to perform the procedure, and your vision improves as the eye recovers from the procedure. Some people may still have to use glasses. 

Glaucoma Surgery 

Glaucoma is a condition that stems from damage to the optic nerve. The damage usually comes from a build-up of pressure in the eye. Glaucoma can cause blindness if it is left unattended. Glaucoma surgery stops the condition from getting worse and relieves the pressure preventing blindness. There are three main glaucoma surgery procedures:

• Trabeculectomy: It is often used to treat open-angle glaucoma with the surgeon making a small incision at the top of the eye under the eyelid. The opening allows for drainage of extra fluid, lowering eye pressure. 
• Glaucoma implant surgery: This treatment for congenital, neovascular, and injury glaucoma. A surgeon implants a tiny tube in the white of the eye to drain extra fluid, relieving pressure.  
• Minimally invasive glaucoma surgery: These are procedures that use microscopic-sized equipment to make tiny incisions. It allows for fast healing but may not be as effective as traditional methods.  

Retina Surgery

Retina surgery involves repairing damaged or detached retina. Several methods are used individually or in conjunction with one another. Diabetes and physical injuries are among of the conditions that necessitate surgery. Among the specific procedures:

• Cryopexy: Doctors use a frozen probe to create scars that help heal a tear or hole, which helps hold the retina in place. 
• Photocoagulation: This is the use of a laser to make a small burn that works as the scars created in cryopexy.
• Scleral buckle surgery: Doctors place a tiny and flexible band around the white part of the eye to gently push the sides of the eye toward the retina, helping it reattach. 
• Pneumatic retinopexy: The ophthalmologist injects a small air bubble in the eye which helps push the eyeball into position, and then the burning or freezing treatment is applied. 

Eye Muscle Surgery 

Doctors perform eye muscle surgeries to treat strabismus, a condition in which the eyes do not move as a pair, with one drifting up, down, in or out. The procedure restores eye muscles to a proper position by either weakening or strengthening the affected muscles. It may include removing part of the muscle or reattaching a muscle to a different part of the eye. 

Macular Degeneration Surgery 

Macular degeneration surgery treats the wet macular degeneration, an acute type of age-related macular degeneration (AMD). (Dry macular degeneration has no treatment.) Surgery involves using a laser to burn away unwanted blood vessels, which often leak and cause dark spots and blurring. Surgery halts bleeding and promotes the growth of additional healthy blood vessels.

Can You Get a Full Eye Transplant?

You cannot get a full eye transplant because the eye has a complex web of blood vessels, muscles and nerves all connected to the brain. All of these cannot be transplanted at once, nor does one find an exact match for each point.

The optic nerve, in particular, cannot be transplanted, and no full-eye transplant would work without it. 

Recovery

Recovery from eye surgery depends wholly on the type of surgery you have the extent of it. Most eye surgeries are outpatient procedures, and normally recovery times range from one day to one week. 

Some procedures leave your eyesight blurry for a few days. For others, you may need a month or two to fully attain the desired clarity. How fast you recover will also depend on your post-surgery care. 

Risks

Like any surgery, eye procedures carry risks. The level of risk also depends on which surgery you need and the complexity of it. Your eye health and overall health also come into play.

Common risks include:

• Short-term blurry vision 
• Inflammation
• Infection
• Damage to other eye parts, especially the retina
• Sensitivity to light
• Visual disturbances like shadows, halos, and glares 
• Bleeding in the eye

Success Rates

Thanks to technological advances for techniques like laser-aided procedures, eye surgeries enjoy a high success rate. Many procedures record over 80 percent success rate, while the LASIK and PRK have the highest rates of success of high than 90 percent.

Further developments are ongoing, which will help drive the prices low and make the procedures more effective while improving recovery times. 

FAQs

Is an eye transplant possible? 

A full eye transplant is not possible at the moment. Surgeons can only transplant parts of the eye like the cornea or lenses.

Can a blind person have an eye transplant? 

Yes, but only if the blindness is caused by something a surgery can fix, like a cornea transplant. However, if the optic nerve is damaged, no surgery can fix it. 

What is the cost of an eye transplant?

The cost of eye transplant surgery varies with the procedure. It often starts at $3,000 and goes up to $10,000 or more, especially for procedures like corneal transplants. If you have insurance to cover the procedures, the cost will be significantly cheaper.

References

1. What Is Macular Degeneration? (February 2022). American Academy of Ophthalmology.

2. What Is the LASIK Success Rate? (October 2021) American Academy of Ophthalmology.

3. Photorefractive Keratectomy (November 2021). StatPearls.

4. Cataract Surgery: Risks, Recovery, Costs (September 2021) American Academy of Ophthalmology.

5. Cornea Transplant (July 2021). National Health Service.

6. Surgery for Retinal Detachment (December 2020). Surgery for Retinal Detachment.

7. Whole-eye transplantation: A look into the past and vision for the future. (February, 2017). Eye.

8. What Is Refractive Surgery? (December 2015) American Academy of Ophthalmology.

9. Chapter 82 – Preoperative evaluation of the refractive surgical patient. (2009). Corneal Surgery (Fourth Edition).