For the past decade and a half I have been suffering from keratoconus-like symptoms and have tried multiple treatments. They have had me wearing toric lenses for the past few years, but are beginning to fail. Before this, they had my wearing gas permeable hard lenses that were not working well for me. At this point, I'm looking for a solution to this problem and have been considering a corneal transplant. For those of you who are interested in ophthamology or in an ophthamology residency give me the pros and cons of a corneal transplantation, risks vs. benefits, potential cost, and recovery time please? I want to become a surgeon and I'm hoping that a procedure such as this will not compromise that hope. I appreciate your help.

Blake

If your vision remains bad with contact lenses, then you likely need to consider a penetrating keratoplasty procedure (PKP),

Following the PKP, there is a long process of rehabilitation and care. You need frequent follow-ups with the cornea specialist, and there may be high astigmatic error until stitches are removed gradually. You'll need to use steroid drops to fight rejection and failure. Also, any sign of infection in the graft is a medical emergency.

The risks of a PKP: pain, discomfort, decreased vision, infection, severe hemorrhage due to hypotony during the procedure with possible subsequent loss of the eye and vision, graft failure, and needing repeat PKP. If things are done under general anesthesia, then there are the small risks of stroke and death.

"... For those of you who are interested in ophthamology or in an ophthamology residency give me the pros and cons of a corneal transplantation, risks vs. benefits, potential cost, and recovery time please? I want to become a surgeon and I'm hoping that a procedure such as this will not compromise that hope. I appreciate your help.

Blake

Dear Blake,

1. Rehabilitation may entail up to a year's worth of follow up.
2. Although recent microsurgical techniques have increased the uncorrected vision post PKP to 20/25 in at least 90% of the cases, there is still a probability that you might still need either spectacle either and or contact lens correction post-surgical. With 20+ years rehabilitating post PKP cornease with contact lenses, this is still an uncertain science.
3. Graft failure can occur at any time, sometimes many years later.
4. Grafts require good beds. Such things as limbal stem cell problems, occult Herpes Simplex, etc, can surprise a surgeon or complicate the post-op period.

Regards,
Richard_Hom