In the 2008 film Seven Pounds, the protagonist, played by Will Smith, causes a terrible car accident that kills six people, including his fiancée. In an attempt to atone for his actions, he concocts a plan whereby he will save seven lives by committing suicide and donating his organs to deserving people who need them. One of the recipients, a blind man played by Woody Harrelson, gets the Fresh Prince’s eyes. In a climactic scene at the end of the film, Woody’s character looks into the camera and we see that his formerly blue eyes are now brown, the implication being that he has been the recipient of whole-eyeball transplants.
In the wake of that film’s release, we received quite a few questions to the effect of, “Is that possible? Can you get eyeball transplants?” The short answer is “no.” Woody getting Will’s eyeballs surgically placed into his eye sockets is one of the more implausible moments in a film full of them. The eyes are connected to the brain via the optic nerve, which is made up of hundreds of thousands of fibers. Linking those up from donor to recipient is far beyond the scope of modern medicine.
What is possible, however, is cornea transplantation. The cornea, the clear tissue at the front of the eye, is our window to the world. However, injuries, degenerative conditions such as keratoconus, and certain infections can affect the cornea, causing loss of vision. Corneal scarring and opacity are among the leading causes of vision loss worldwide, and can only be treated by cornea transplants. Fortunately, in the hands of a properly trained cornea specialist, cornea transplantation is a very safe procedure with high probability of a good outcome. In fact, cornea transplants are among the most commonly performed tissue transplant procedures in the world, restoring sight to tens of thousands of people annually all over the world. Since the cornea is avascular (containing no blood vessels), it is not necessary to match blood types between the donor and recipient. Incidence of tissue rejection is relatively low compared to most other transplant procedures.
Until recently, the only form of transplant procedure available was penetrating keratoplasty, or PK, where a circular disc of corneal tissue is removed from the donor cornea, placed into a similarly-sized space in the recipient’s cornea, and secured with sutures. While PK still comprises the vast majority of corneal transplant procedures, and is still the best option for many patients, there have been several recent advancements in transplant technology.
In the early 2000s, a new procedure, deep anterior lamellar keratoplasty (DALK), was introduced. DALK differs from PK in that the recipient’s innermost layer of corneal tissue, or endothelium, is left intact, with only the central and outer layers being replaced with donor tissue. DALK represents an advance over PK in that the chances of the patient’s body rejecting the corneal graft are lower. The corneal specialists at Hoopes Vision are experienced in all of the newest and most effective transplant procedures, and are among the select handful of surgeons performing the very newest wave of laser-assisted cornea transplants, in which a computer-guided laser is used to harvest the donor cornea and prepare the patient’s graft site.
It is certainly our hope that you never find yourself in need of a cornea transplant, but if you do, you may rest assured that it is a safe, effective procedure that restores good vision in the large majority of patients. (You may also rest assured that when you look in the mirror the next morning, your eye color will be unchanged.)