Recipient Information

Placement for Corneal Transplantation

Only a thorough examination by an ophthalmologist can determine if an individual could benefit or is ready for a corneal transplant. When an ophthalmologist determines that a patient requires a cornea transplant, the patient's name is listed on the Lions Corneal Donation Service's surgery schedule. The date of the surgery will be determined by available surgeon, anaesthetist and operating theatre time, the patient's own wishes, and importantly, an estimate by the Lions Corneal Donation Service on the availability of a donor cornea for a particular date.

Costs

Patients electing to have their transplant performed privately should discuss all costs with their chosen ophthalmologists - these will include surgeon fee, anaesthetist fee, hospital bed, operating theatre and other charges. It should also include Lions Corneal Donation Service fees.

While it is illegal to buy or sell human eyes, organs and tissues, Lions Corneal Donation Services are allowed to recover their costs involved in the eye donation. They do this through the charging of a service fee for the provision of the cornea. Expenses to the Lions Corneal Donation Service include staff salaries, laboratory testing, equipment and maintenance, medical comsumables, office supplies, utlities and infrastructure costs. If the patient has private health insurance, the health insurer will pay 100% of the service fee levied by the Lions Corneal Donation Service - Melbourne. If the patient elects to go privately but without medical insurance they will be liable to pay the Corneal Donation Services fee - it is not covered by the Medicare national health system.

If you elect to have your transplant performed under the public health system in a public hospital, the Lions Corneal Donation Service will recover their costs directly from the State Government Health Department.

Preparing for Surgery

Prior to surgery the patient is given laboratory tests that may include blood and urine tests, ultra-sounds, x-rays, electrocardiograms and further eye tests. Patients are instructed not to eat or drink eight hours prior to their scheduled surgery. In most cases the surgery is performed as a day procedure and will not require an overnight stay in hospital. However, a patient's needs will vary.

Surgery

Cornea transplant surgery may be performed under general or local anesthesia. The patient's face is cleansed and prepared and covered with sterile operating sheets. So fine is the surgery that the surgeon performs the operation looking through a surgical microscope.

The patient's own diseased or damaged cornea is removed with a cylindrical cutting instrument. The donor's cornea is cut similarly so the shapes are indentical. The clear, healthy donor cornea is placed in the opening where the patient's old cornea was removed. The donor cornea is then sewn into place with sutures (stitches) that are less than half the thickness of a human hair.

After Surgery

After surgery the patient's eye is patched with eye pads and covered with a hard plastic shield to protect it from injury. The day after the surgery the ophthalmologist examines the eye and then usually puts the patch back on. Many patients are able to open their eyes and notice visual improvements immediately.

The patient will be instructed on how to use the necesary medications, which may be ointments or eye drops, and given a treatment schedule to follow.

Recovery

The early recovery period will vary between one to three weeks following surgery. During this time the patient should aviod rubbing their eyes. Any activity that will increase blood presure to the head or the eye should also be avoided, including heavy lifting, straining that requires holding ones breath or bending over lower than the waist.

Recipients should not undertake activities that require good vision (such as driving a car) while their eye is patched or until their vision is adequately restored. It is also very important for patients to keep every follow-up appointment with their doctor throughout the recovery period and to use medication exactly as prescribed.

Warning Signs

If the patient's body begins to reject the transplant of if any other problems occur, the situation can often be remedied if the patient contacts an ophthalmologist immediately. If a transplant does fail another corneal transplant can be performed.

In particular, transplant recipients must watch for the following:

• Redness of the eye
  For the first few weeks after surgery, the eye will be red and become less so as time goes by. However, if there is any substantial increase in redness or redness after the recovery period please contact an ophthalmologist.
• Light sensitivity
  Some light sensitivity after surgery is expected and it should gradually decrease. If the eye becomes more sensitive to light than usual then contact an ophthalmologist.
• Vision Loss
  Patients are advised to select an object at home to test their vision on every day. Changes in vision are expected, but if the check appears more cloudy or blurred than previously then contact an ophthalmologist.
• Pain
  Small twinges of pain during the healing process are expected. However inform the ophthalmologist if the eye hurts or throbs steadily for more than two or three hours.