Full-thickness corneal transplant
When both the inner and outer layers of the cornea are damaged, your surgeon may need to replace the full thickness of the cornea. This is known as penetrating keratoplasty (PKP). The damaged cornea will be removed, and a donor cornea will be stitched in place.
Partial-thickness corneal transplant
If only the outer and middle layers are damaged, your surgeon may replace only these layers through a procedure known as deep anterior lamellar keratoplasty (DALK). The recovery time for DALK is typically less than that of PKP, and the risk for transplant rejection is lower.
Endothelial keratoplasty
The innermost layer of the cornea is known as the 'endothelium'. If only this layer is damaged, your surgeon may replace it through one of two procedures:
- Descemet's Stripping (Automated) Endothelial Keratoplasty – DSEK(DSAEK)
- Descemet's Membrane Endothelial Keratoplasty – DMEK
In both of these, the inner layer is removed through a small incision, the donor tissue is inserted and the incision is closed with a few stitches. The procedures differ in the thickness of the donor tissue. The donor tissue for the DMEK surgery is thinner than for the DSEK surgery, resulting in a typically faster recovery.
Pre-Admission Visit
What should I bring to my pre-admission appointment?
If you are asked to attend the preadmission clinic, please bring
- Your health card (OHIP card). If you do not have an OHIP card, please bring another form of government-issued photo ID, such as a driver's license or passport.
- Any other insurance cards. You will need the policy number of your extended health insurance, if you have any.
- Your spouse/partner, a trusted friend or family member (to offer you support and be a second set of ears).
- All the medications you take in their original containers. This includes prescription medications, over-the-counter medicines, vitamins, supplements and herbal or natural products.
- A copy of your power of attorney for personal care and/or advanced directives.
- A list of any questions that you may have about the operation and recovery.
- The name or phone number of your pharmacy, as well as any medical specialists that you have seen in the past 3 years.
- If you have had a cardiac stress test, echocardiogram and/or a pulmonary function test in the past 3 years, it would be helpful to bring a copy of the final report with you to this appointment.
What happens during my pre-admission visit?
- You will have blood tests and routine skin swabs. The swabs are taken from your nose and other areas of your body to check for germs that can cause infections.
- You may also need an
electrocardiogram (ECG) to check your heart and a chest
x-ray to check your lungs.
- You will meet many health care providers during your pre-admission visit. Please feel free to ask them any questions that you may have.
- A pre-admission nurse will review your health history and give you information to prepare you for your operation, including directions for cleaning your skin, eating before your operation, taking your medications and pain management.
- A pharmacist will review your medications.
Depending on your needs, you may also meet:
- An anesthetist who will review your health history, discuss your anesthetic plan and pain relief after your operation.
- A member of the medicine team, if you have other complex health problems.
Stop smoking before your surgery: learn how smoking and tobacco can affect your recovery after surgery, and how
quitting can improve your health.
What should i do the day of my surgery?
Arrive 2 hours before your scheduled operation time.
Day Surgery Unit (DSU) at
Toronto Western Hospital
Main Pavilion – 4th Floor, take the Atrium Elevators
All hospital entrances are open by 6:00 am. However, the Leonard entrance (between Nassau St. and Wales Ave.) is easiest to access.
You will continue to recover when you return home.
| Activity | How to manage at home |
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| - You can go back to eating and drinking what you normally would. Slowly start by having fluids and soups on the day of the surgery. Then return to your normal diet the next day.
- If you are feeling nauseated (sick to your stomach) or vomiting, you can buy anti-nausea medicine from your local pharmacy without a prescription (such as Gravol, taken as a pill or rectally). Always follow the instructions on the package.
- Keep drinking fluids until the nausea passes. Then gradually return to your normal diet.
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| - If your surgeon has instructed you to lie flat, continue to lie flat for the rest of the day. You may get up to go to the bathroom, eat and to return to your follow-up appointment. Your surgeon will let you know how long you must stay in this position. The DSEK and DMEK procedures will usually require you to lay flat on your back for 24 hours.
- If you do not have to lay flat, you can go back to your normal activities when you feel ready. It is safe to bend at the knees, read, watch TV, cough, sleep on any side, and go for walks.
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| - Do not do anything that would strain or put pressure on your eye.
- Do not do strenuous physical activities like swimming, gardening, shoveling snow, jogging, aerobics, or having sex for 1 month after your surgery. Your surgeon will let you know when it is safe to play sports again.
- Do not lift anything heavier than 5 kilograms (10 lbs). For example, do not carry groceries, lift young children or pets.
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| - Avoid straining when having a bowel movement.
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| - If you have not taken your usual daily medicines, take them as soon as you get home.
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| - DO NOT drive a car or operate a vehicle. Your surgeon will tell you when it is safe to drive again.
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| - Your surgeon will tell you when you can go back to work.
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| - You can take a shower or bath 24 hours after your surgery.
- When you shower or wash your hair, keep your eye closed to keep water and soap out.
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Where and when
Cornea & Anterior Segment Disease Service
Toronto Western Hospital | East Wing – 6th Floor
Follow-up appointments may be scheduled for the following day, one week later and monthly.
If you do not have a follow-up appointment, call the surgeon's office to schedule one.
