Eye Disease
5 min read

Corneal Grafts

Published on
December 4, 2023
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Corneal grafts are required for clear vision when the cornea is compromised due to scarring or dysfunction. After the cornea from a donor is implanted into the eye, careful monitoring is required by your optometrist to ensure its viability in the future. Often glasses or specialised contact lenses such as RGPs or sclerals are required to give good vision in an eye with a graft, due to the frequently irregular front surface.

At Innovative Eye Care we are often asked by ophthalmologists and other optometrists to help patients who have had corneal grafts achieve the best vision possible. Sometimes we can manage this with spectacles, but more often we have the best success with large diameter scleral lenses, for a variety of reasons.

Slit lamp biomicroscope cross section of a full thickness corneal graft
Figure 1. Cross section of a corneal graft, demonstrating the differences in thickness between the host and graft tissue.

The donor cornea is often irregular in shape, and this makes it very difficult to fit a standard RGP or soft contact lens. A scleral lens will vault over a grafted eye without touching the surface. Not only is this good for vision but also for comfort and healing from the surgery.

This is especially important due to the risk of graft-rejection. If the donor tissue is chronically inflamed or traumatised, the body may identify the new corneal tissue as foreign, causing scarring and loss of function. A poorly fitting lens resting on the eye makes this more likely to occur. This can be devastating for the patient (not to mention uncomfortable) as it may mean a second graft is required. Light sensitivity is a very important symptom to watch out for if you have a sore corneal graft as this may indicate impending rejection. You should visit your optometrist as soon as possible if this occurs.

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