Recovery after corneal transplant: month by month

Two styles of graft are described in the leaflets, and their recoveries differ. Inner-layer grafts replace only the lining of the cornea through a small incision. Full-thickness and partial-thickness grafts replace more of the cornea and use stitches that stay in longer. Knowing which one you have is the first step in reading any timeline, including this one.

Details of the operation are in the corneal transplant guide. The figures below are typical ranges described in published leaflets; your surgeon's plan takes priority.

After an inner-layer graft, Moorfields describes an air bubble holding the donor tissue in place and lying flat for one to two hours. You are usually examined and sent home the same day. Within a week you return to check that the graft has remained in position, because, according to Moorfields, around 10% of DSAEK grafts and 20% of DMEK grafts shift and need repositioning with an air or gas injection.

Wash your hands before and after using drops or touching a dressing, as the Dudley leaflet says. Use the drop schedule exactly as written, and ask your team what protection the eye needs while it heals.

For an endothelial graft, Moorfields suggests about two weeks off work and says its one or two stitches are removed in clinic in the weeks after the operation. For conventional grafts the Dudley leaflet says two to three months off work may be needed, and longer if there is a risk of eye injury, though a desk-based job carries less.

Vision in this period is typically blurred and may fluctuate. The Dudley leaflet says the vision is usually blurred for several months with very gradual improvement. In inner-layer grafts, stitches are removed at around three to four months. A scheduled series of visits checks pressure, graft clarity and drops.

Drops continue. Moorfields says anti-rejection drops should last at least six months, and the Dudley leaflet says they are needed for several months and sometimes indefinitely. Both leaflets stress attending every review. After conventional grafts, the Dudley leaflet says some people have excess astigmatism and may need glasses, contact lenses or further surgery after the stitches are out.

The Moorfields leaflet says that, for endothelial grafts, the majority of recipients have good enough vision to drive legally, usually with glasses, and that it can take up to six months to see the full improvement.

Visits become less frequent. The Dudley leaflet says to be prepared for at least 12 over the first two years, and more if problems arise. Rejection remains possible throughout your life, according to Moorfields, so a new red or painful eye is always worth a call. Transplants can fail years later, the Dudley leaflet says, though many show long-term success.

Driving depends on your sight meeting the legal standard, not on a date. GOV.UK requires you to read a number plate from 20 metres, with glasses or lenses if needed, and to meet a minimum visual acuity. If a graft leaves one eye poor, the legal standard still applies to what you can see with both eyes together, or the remaining eye if you have one. GOV.UK also says to ask your doctor about driving after an operation and to tell the DVLA if you are still unable to drive three months later.

Moorfields notes that endothelial grafts have a smaller wound and so fewer problems such as leakage or rupture after accidental injury than full-thickness grafts, and the Dudley leaflet links time off work to the risk of eye injury. Ask your team about contact sports, swimming and eye protection.

Moorfields lists red eye, sensitivity to light, loss of vision and pain as symptoms of rejection, which needs urgent treatment. The Dudley leaflet says most rejection episodes are reversible if treated early and vigorously, so contact the clinic if you notice a sudden change. Use the eye emergency number you were given, and NHS 111 or A&E if you cannot reach it.