Cornea Transplant: Procedure, Cost, Success & Recovery

Cornea Transplant

Treatment Duration

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45 Minutes

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60 Minutes

Treatment Cost

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90,000

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1,70,000

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Cornea Transplant

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According to a study by Venugopal et al., 2023, 1.2 million people in India have corneal blindness. Cornea transplant surgery is the only effective treatment for this condition. This procedure can significantly restore vision. 

The goal of the surgery is to restore the patient’s vision clarity. But what does a cornea transplant cost, and what can you expect after the procedure? Please continue reading for the price, steps, benefits, recovery, and more. 

Procedure Name 

Cornea Transplant 

Alternative Name 

Keratoplasty, corneal graft 

Conditions Treated 

Keratoconus, Fuchs dystrophy, corneal ulcers 

Benefits of the Procedure 

Vision clarity, minimally invasive

Treated By 

Ophthalmologist

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What is a cornea transplant?

A cornea transplant is a surgery to replace a damaged cornea with healthy donor corneal tissue. Depending on the nature and severity of the patient’s condition, the procedure can involve replacing the entire cornea or a part of it. 

The types of cornea transplant approaches are as follows: 

  1. Penetrating Keratoplasty: This is a full-thickness corneal transplant in which the entire damaged cornea is removed and replaced. It is used when all the layers of the cornea are opaque. 

  2. Endothelial Keratoplasty: It replaces the inner layer of the cornea with healthy donor tissue. The procedure is recommended for endothelial diseases like Fuchs’ dystrophy. 

  3. Anterior Lamellar Keratoplasty: The surgery involves replacing the outermost corneal layers. It is ideal for conditions like keratoconus or scarring that affects only the outer layers.

  4. Keratoprosthesis: In cases where traditional transplantation is not feasible due to severe damage, an artificial cornea may be implanted to restore vision.

Anatomy and Physiology of the Cornea

The cornea is the transparent, dome-shaped front layer of the eye. It is responsible for refracting (bending) light entering the eye, focusing it onto the retina to form clear images. 

The cornea has five layers, which are as follows: 

  1. Epithelium: This is the outermost layer that acts as a protective barrier against foreign substances and absorbs oxygen and nutrients.

  2. Bowman’s Layer: A strong layer made of collagen that provides structure and shape to the cornea. 

  3. Stroma: The thickest layer that gives the cornea its structure and transparency.

  4. Descemet’s Membrane: It is a thin, strong layer that acts as a barrier against infection.

  5. Endothelium: The innermost layer maintains corneal clarity by removing excess fluid from the stroma.

Conditions Treated With Cornea Transplant

A cornea transplant can be recommended for several diseases that cause significant damage or vision impairment. The following are some key conditions that may be treated with this surgery: 

  1. Keratoconus: In this progressive condition, the cornea thins and bulges into a cone shape. It leads to distorted vision.

  2. Fuchs’ Dystrophy: It is a genetic disorder that affects the corneal endothelium, leading to fluid buildup, swelling, and eventual vision loss.

  3. Corneal Scarring: This can result from injury, infection, or inflammation, significantly reducing vision. 

  4. Corneal Ulcers: Severe infections can cause corneal ulcers or abscesses, affecting eyesight. 

  5. Previous Corneal Surgery Complications: Failed or rejected cornea grafts from previous transplants or complications from other eye surgeries may require another transplant.

Who needs a cornea transplant?

Ideal patients for a cornea transplant include those with significant vision impairment due to corneal damage that cannot be corrected with other treatments. The procedure restores vision, reduces eye pain, and treats severe damage or infection. 

It also relieves other symptoms associated with corneal diseases, including: 

  1. Sensitivity to light 

  2. Gritty eyes 

  3. Watery eyes 

  4. Redness in the eyes 

  5. Discharge from the eyes

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Cornea Transplant Procedure

Cornea transplant surgery is performed under general (the patient is unconscious) or local anaesthesia (the area to be treated is numbed). The procedure is completed within two hours. The exact steps of the operation can vary depending on its type:

  1. Penetrating Keratoplasty: This is the oldest and most common technique, which involves the following:

    1. A small circular blade removes the entire centre of the damaged cornea.

    2. The same-shaped tissue of cornea tissue is placed in this opening. 

    3. The surgeon places sutures to hold the donor cornea in place. 

  1. Endothelial Keratoplasty: It can be of two types, which include Descemet stripping endothelial keratoplasty (DSEK) and Descemet membrane endothelial keratoplasty (DMEK). The procedure steps include: 

    1. The surgeon removes the endothelium and the Descemet membrane from the back layers of the cornea.

    2. They use donor tissue to replace the removed tissue. 

    3. An air bubble is used to keep the donor cornea in place.

  1. Anterior Lamellar Keratoplasty: It can also be performed using two techniques, which are as follows:

    1. In superficial anterior lamellar keratoplasty (SALK), only the front layers of the cornea are removed. The healthy stroma and endothelium are left intact. 

    2. In deep anterior lamellar keratoplasty (DALK), the front layers are removed along with the stroma. 

    3. Healthy donated corneal tissue replaces these parts of the cornea.

Note: The choice of transplant procedure depends on the specific condition affecting the patient’s cornea and the surgeon’s recommendation.

Before and on the Day of the Cornea Transplant

Before undergoing a cornea transplant, patients are guided through essential preparations to ensure an effective procedure. This preparatory phase is crucial for minimising potential complications and optimising the success of the transplant.

Before Cornea Transplant 

At the initial visit, the ophthalmologist explains the procedure and provides specific guidelines for preparations. Once the patient is clear for the surgery, patients wait for a donor cornea to become available. One can expect the following before a cornea transplant: 

Parameters 

Pre-requisites 

Pre-op Assessments 

  1. A complete eye exam 

  2. Measurement of the size of the cornea 

Risk Evaluation 

  1. Allergies 

  2. Surgery benefits vs risks 

Restrictions 

  1. Blood thinners 10 days before the procedure

  2. Alcohol 24 hours prior to the operation 

Anaesthesia Selection 

General or local 

Fasting 

6-8 hours before surgery 


On the Day of Cornea Transplant 

Patients should arrange for someone to drive them home after the procedure. Once they reach the hospital, the following is what usually takes place: 

Parameters 

Pre-requisites 

Consent 

Mandatory 

Patient Preparation 

  1. Wear loose, comfortable clothes

  2. Avoid lotions, creams, and makeup on the face and around the eyes 

Physical Evaluation 

Vitals check-up (blood pressure, heart rate, temperature, etc.)

IV Line 

Yes, for fluids and medications 

Patient Positioning 

Supine (lying flat on the back) 

After the Cornea Transplant and Recovery

Mild redness, irritation, and sensitivity to light are common for the first four days after the procedure. The doctor provides instructions to manage this discomfort and ensure a successful recovery. 

In Hospital Recovery 

Patients can often return home on the same day of the surgery. Before discharge, they are moved to a recovery room, where the nursing staff monitors their vitals. The doctor prescribes pain medications to manage any discomfort. 

At-home Recovery 

The recovery duration after a cornea transplant can differ depending on the type of procedure. 

Restoration of complete vision after a full-thickness transplant takes about one year. However, after an endothelial corneal transplant, good vision may be achieved within three months. 

During this period, patients can expect the following: 

  1. Take prescribed antibiotics and anti-inflammatory eye drops to prevent infection and reduce swelling. 

  2. Over-the-counter or prescribed pain relievers can help manage pain, irritation, and light sensitivity. 

  3. Place an eye patch over the operated eye for one to four days. 

  4. Wear glasses or other protective eyewear to protect the eyes from accidental rubbing or injury. 

  5. Patients should lie on their back after surgery for endothelial surgery to help the tissue stay in place. 

  6. Do not engage in activities like contact sports and swimming until the doctor approves. 

Follow-up Appointment

The first follow-up appointment is scheduled one to two days after the procedure. The doctor removes the eye patch during this visit and monitors the healing process. Depending on the type of surgery, sutures may need to be removed gradually over several months as the eye heals.

Benefits of Cornea Transplant

With modern techniques, the surgery has become a reliable treatment for many corneal diseases. The cornea transplant success rate is about 95%. The multiple benefits of this procedure are as follows: 

  1. Restores Corneal Clarity: The transplant replaces a damaged cornea with a clear donor cornea, allowing light to enter the eye without obstruction.

  2. Selective Layer Replacement: Advanced procedures like DSEK or DMEK target only specific layers, leaving healthy layers intact. 

  3. Customisable Approach: Different types of corneal transplants (full or partial thickness) allow surgeons to tailor the procedure to address each patient’s unique condition.

  4. Minimally Invasive: Modern techniques like endothelial keratoplasty have made the procedure less invasive. This results in a shorter recovery (about three months) and reduced discomfort.

Risks and Complications of Cornea Transplant

Although cornea transplant surgery is generally safe and successful, there is still a minor possibility of serious complications. One of the major risks is graft rejection, which occurs in about 10% of cases. Other complications of the procedure may include the following: 

  1. Infection inside the eye or in the cornea

  2. Glaucoma (elevated eye pressure) 

  3. Problems with the sutures holding the graft in place 

  4. Bleeding 

  5. Detachment of retina 

  6. Detached cornea transplant 

  7. Leakage of fluid from the cornea 

When to call a doctor? 

After a cornea transplant, patients must monitor their eye health closely. They should contact their doctor if they experience any of the following symptoms of cornea rejection:

  1. Eye pain 

  2. Redness in the eye

  3. Vision loss 

  4. Sensitivity to light 

It is also important to seek medical attention for signs of infection, such as fever and eye drainage. 

Risks of Delaying Cornea Transplant

Delaying a cornea transplant can lead to several complications that may further impair vision or overall eye health. These risks include: 

  1. Progression of Vision Loss: Conditions like keratoconus, scarring, or corneal dystrophies continue to deteriorate without treatment. This can worsen eyesight. 

  2. Increased Risk of Infection: Severe corneal damage may leave the eye more vulnerable to infections, further damaging vision and requiring immediate medical attention.

  3. Reduced Quality of Life: Vision impairment from untreated corneal conditions can negatively impact daily activities like reading, driving, and working. 

Cost of Cornea Transplant 

The cornea transplant cost in India can vary significantly from one individual to another based on several factors. Generally, the price ranges between  ₹ 90,000 and ₹ 1,70,000. The average expense of the procedure is ₹ 1,10,000. 

Procedure Name 

Estimated Cost Range 

Cornea Transplant 

₹ 90,000 to ₹ 1,70,000

Note: The figures mentioned above are estimates. Please talk to HexaHealth experts for accurate pricing information. 

Factors that affect the expenditure of cornea transplants include: 

  1. Type of Transplant Procedure: Different types of cornea transplants (full-thickness vs partial) require varying surgical expertise and equipment, affecting the overall cost.

  2. Surgeon’s Experience: Ophthalmologists with advanced skills or strong reputations in performing cornea transplants may charge higher fees.

  3. Type of Hospital: Private hospitals generally offer better amenities and more comfort than government centres. This makes the former more expensive. 

  4. Geographic Location: The expense of medical procedures can vary by area due to differences in the cost of living and local healthcare economics. 

  5. Insurance: The extent of health insurance coverage can impact a patient’s out-of-pocket costs.

Takeaway

A cornea transplant restores vision and significantly improves the quality of life for corneal damage patients. By replacing the diseased cornea with a healthy donor graft, the surgery provides a clear path for light to enter the eye. With the appropriate medical care and follow-up, a successful transplant can help patients regain their independence.

At HexaHealth, we are dedicated to guiding patients before and after cornea transplant surgery by providing comprehensive support. Our network of skilled ophthalmologists offers expert surgical intervention and careful postoperative care. We provide the highest quality care to help individuals achieve the best possible outcomes.

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Frequently Asked Questions (FAQ)

 A cornea transplant, also known as keratoplasty, is a surgery in which a damaged cornea is replaced with healthy donor tissue. This procedure aims to restore vision by providing a transparent window through which light can enter the eye.

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A corneal transplant is needed when the cornea is severely damaged or diseased. This can happen due to conditions like: 

  1. Keratoconus

  2. Scarring

  3. Fuchs’ dystrophies

  4. Infections and ulcers

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The exact procedure of a cornea transplant varies based on the type of surgery. However, the steps are as follows: 

  1. General or local anaesthesia is administered. 

  2. The damaged cornea is removed and replaced with donor tissue. 

  3. The surgeon secures the donor cornea with fine sutures or an air bubble for partial transplants.

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The graft survival rate can vary depending on the recipient’s health and the surgical technique. According to a study by Liu et al., 2022, the donor cornea has a survival rate of 90% at five years and 82% at ten years. The rate is 93% or higher at five years for partial transplants like DSEK.

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The cornea transplant cost typically ranges from ₹ 90,000 to ₹ 1,70,000, depending on the procedure type, the surgeon’s fees, and insurance coverage. However, these prices are approximate. Patients should consult HexaHealth professionals for accurate expenses. 

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Yes, corneal transplant surgery is covered under insurance. However, coverage varies by policy. Confirm details with HexaHealth before the procedure.

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Like any surgical procedure, cornea transplant surgery carries certain risks. These include the following: 

  1. Graft rejection 

  2. Infection 

  3. Increased intraocular pressure 

  4. Suture-related complications 

  5. A detached retina or cornea transplant

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A cornea transplant is a life-changing solution for those with severely scarred or diseased corneas. The benefits of the procedure include: 

  1. Vision clarity 

  2. Option for minimally invasive techniques 

  3. Relief from pain 

  4. Enhanced quality of life

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Complete recovery from a cornea transplant depends on graft type, healing rate, and suture removal. For penetrating keratoplasty, complete vision is restored in about one year. In contrast, patients can expect good vision three months after endothelial corneal transplant. 

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Cornea transplant success rate is approximately 95%, with most surgeries achieving improved vision. Success largely depends on the patient’s overall health and adherence to postoperative care.

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A cornea transplant can significantly improve vision for many patients, especially those suffering from advanced corneal conditions. However, long-term success depends on maintaining eye health, regular follow-up visits, and managing underlying conditions that could affect graft health.

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Various factors can affect the success of a cornea transplant procedure. These include: 

  1. The patient’s health 

  2. Postoperative care 

  3. The severity of the condition 

  4. Donor graft quality 

  5. Effective management of complications

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The major complication of cornea transplant (10% of cases) is graft rejection, which causes eye pain, redness, vision loss, and sensitivity to light. Other risks may include: 

  1. Infection 

  2. Detached retina 

  3. Glaucoma 

  4. Problems related to sutures

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A cornea transplant is performed under local or general anaesthesia, making the procedure painless. However, mild discomfort, irritation, and light sensitivity may be experienced during recovery. Patients can manage this with eye drops and pain medications prescribed by the doctor.

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Rejection can occur after a cornea transplant if the body’s immune system attacks the donor graft. It is managed with medications like corticosteroid eye drops or oral immunosuppressants. Early detection through regular follow-ups is crucial for successful treatment.

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Precautions before and after cornea transplant are important to ensure a smooth recovery. Patients should follow these guidelines post-procedure: 

  1. Wear protective eyewear. 

  2. Avoid rubbing the eye. 

  3. Follow the prescribed medication regimen. 

  4. For endothelial transplant, lie on the back after the surgery to ensure the tissue stays in place.

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Most patients can resume normal activities and work within a week or two. However, full recovery may take several months. Therefore, avoid strenuous activities, swimming, or any action that could risk eye injury until the doctor approves.

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Vision after a corneal transplant varies by patient and surgical technique. Traditional corneal transplants can restore vision to 20/30. However, advanced procedures like DMEK can offer perfect 20/20 vision after surgery.

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The donated portion is the cornea, the clear layer covering the front of the eye. The entire cornea or specific layers can be transplanted to replace the damaged tissue. It restores vision and provides a transparent window for light.

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A cornea transplant can restore vision if the blindness is due to corneal disease. However, blindness from other conditions involving the retina or optic nerve cannot be corrected by this procedure, as it does not replace the whole eye structure.

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References

All the articles on HexaHealth are supported by verified medically-recognized sources such as; peer-reviewed academic research papers, research institutions, and medical journals. Our medical reviewers also check references of the articles to prioritize accuracy and relevance. Refer to our detailed editorial policy for more information.


  1. Venugopal Anitha, Tandon R, Shah SG, Radhakrishnan N, Singh S, Murugesan Vanathi, et al. Corneal blindness and eye banking: Current strategies and best practices. Indian Journal of Ophthalmology [Internet]. 2023 Aug 21 [cited 2023 Nov 28];71(9):3142–8.link
  2. Healthline Editorial Team. Cornea Function, Definition & Anatomy | Body Maps [Internet]. Healthline. 2018.link
  3. Cleveland Clinic. Cornea: What It Is, Common Disorders & Preventing Injury [Internet]. Cleveland Clinic.link
  4. Cornea transplant [Internet]. nhs.uk. 2017.link
  5. Cornea transplant - Mayo Clinic [Internet]. Mayoclinic.org. 2018.link
  6. Corneal Disease: Keratitis, Eye Herpes, & More [Internet]. Cleveland Clinic. link
  7. Corneal Transplantation [Internet]. www.hopkinsmedicine.org.link
  8. Corneal transplant: MedlinePlus Medical Encyclopedia [Internet]. medlineplus.gov. link
  9. Corneal Transplant: Preparation, Procedure & Risks [Internet]. Healthline. 2012 [cited 2024 May 9]. link
  10. Cornea Transplant Surgery: What You Need to Know [Internet]. WebMD.link
  11. Shweta D. The Benefits of Corneal Transplant Surgery [Internet]. EyeMantra. 2023 [cited 2024 May 9].link
  12. Shweta D. The Benefits of Corneal Transplant Surgery [Internet]. EyeMantra. 2023 [cited 2024 May 9].link
  13. Ball J. The benefits of the cornea transplant [Internet]. Custom Vision Clinic. 2007 [cited 2024 May 9].link
  14. Cornea Transplants [Internet]. NewYork-Presbyterian. [cited 2024 May 9].link
  15. Keratoconus [Internet]. Cleveland Clinic.link
  16. Any harm in delaying a corneal transplant for an opacity? [Internet]. American Academy of Ophthalmology. 2014 [cited 2024 May 9].link
  17. Liu S, Wong YL, Walkden A. Current Perspectives on Corneal Transplantation. Clinical Ophthalmology. 2022 Mar;Volume 16:631–46.link
  18. Seeing a Clearer Picture New: Corneal Transplant Procedure Transforms Woman’s World [Internet]. www.muhealth.org. [cited 2024 May 9].link
  19. About cornea donation [Internet]. NHS Organ Donation.link
Disclaimer: The information provided here is for educational and learning purposes only. It doesn't cover every medical condition and might not be relevant to your personal situation. This information isn't medical advice, isn't meant for diagnosing any condition, and shouldn't replace talking to a certified medical or healthcare professional.

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Dr. Jaideep Dhama

Dr. Jaideep Dhama

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Dr Jaideep Dhama is a well-known Ophthalmologist currently associated with Healthport Clinic. He has 24 years of experience in Ophthalmology and worked as an expert Ophthalmologist in different cities of India.

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