How Much Do Cornea Transplants Cost?

Damage to the cornea — the clear protective covering of the eye — can cause vision loss. Whether the damage stems from injury, disease, or infection, it can be treated with a cornea transplant. This corrective surgery is known as keratoplasty, or corneal graft. It removes the existing cornea and replaces it with another.

These surgeries almost never require hospitalization. 99% of them take place in an ambulatory care facility or on an outpatient basis. And the success rate is high. Post-transplant, an estimated 80% to 90% of patients report clear corneas after 1 year.

What’s the average cost of a cornea transplant?

The cost will vary based on several factors, including:

• Severity of your condition

• Type of procedure

• Preparation of tissue grafts

• Surgeon’s fee

• Geographic area where it’s performed

• Medications prescribed

• Time period being analyzed

Still, some specific data does exist. According to the Eye Bank Association of America, the national average cost of a cornea transplant in 2011 was $16,500 (roughly $19,880 in 2021 dollars). This total included costs for the surgeon, anesthesia, surgery facility, and the tissue itself.

In 2020, consulting firm Milliman projected the average billed charge for a cornea transplant in the U.S. to be $32,500. The projection totaled up 7 months’ worth of medical costs and outpatient medication expenses.

Surgical techniques

• Penetrating keratoplasty (PK): This procedure involves a full cornea transplant. Surgeons use it for treating traumatic eye injuries. They also use it for a condition known as keratoconus, when the cornea thins and becomes misshapen, affecting vision. The average estimated cost for PK in 2011 was $18,907 for people under 65, and $16,783 for people 65 or older. Adjusted to 2021 dollars to reflect inflation, those figures are $22,783 and $20,223, respectively.

• Anterior lamellar keratoplasty (ALK): With ALK, only part of the cornea is replaced. This technique is more difficult for the surgeon. However, it tends to deliver better outcomes in keratoconus cases. Its average estimated cost in 2011 was $11,062 for people under 65 and $16,408 for people 65 or older. In 2021 dollars, those costs are $13,329 and $19,771.

• Endothelial keratoplasty (EK): This approach entails replacing the inner corneal barrier. EK may be used for conditions like Fuchs’ endothelial corneal dystrophy and congenital hereditary endothelial dystrophy. In 2011, this type of surgery cost an average of $20,953 for people under 65 and $16,343 for people 65 or older. Those amounts in 2021 dollars are $25,248 and $19,693, respectively.

Medications

After the transplant, doctors commonly prescribe medicines for healing. These often include steroids such as prednisone, plus cyclosporine or other immunosuppressant drugs.

Post-transplant immunosuppressants are a must to prevent the body’s rejection of the new tissue. The combination of anti-rejection, anti-inflammatory, and other medications can be costly. The United Network for Organ Sharing estimates you could spend $10,000 or more per year.

Who qualifies for cornea transplants?

Transplants can be a treatment option for people with damaged corneas from:

• Keratoconus

• Fuchs’ endothelial corneal dystrophy

• Congenital hereditary endothelial dystrophy

• Eye trauma

• Scarring or ulcers on the cornea

• Peripheral ulcerative keratitis

• Complications from prior surgery

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The Eye Bank Association of America reported that more than 49,000 cornea transplants took place last year, making it one of the nation’s most common types of transplant. Even so, in the U.S., there is no waiting list for transplantable corneas.

How much will health insurance help with the cost of a cornea transplant?

It depends. Private health insurance will often cover a cornea transplant when it’s considered medically necessary for specific conditions. For instance, Aetna regards cornea transplantation as medically necessary for corneal opacity and bullous keratopathy but not for correction of refractive errors (blurred vision). Meanwhile, Capital BlueCross finds transplants medically necessary in cases of chemical injuries, severe infections, or corneal degeneration, among others.

Your health insurance should cover most of the transplant expense once you’ve hit your deductible. An 80%/20% coinsurance split is typical. If your share of the costs reaches your policy’s out-of-pocket maximum, your insurer will cover 100% of further in-network costs. As always, it’s a good idea to contact your insurer and confirm plan details in advance.

Medicare classifies cornea transplants as organ transplants and will therefore cover them for certain conditions under Medicare Part B. In that case, you’re responsible for the Part B deductible ($233 in 2022). You should also expect to pay 20% of the Medicare-approved amount for the surgery and 20% of the price of immunosuppressant drugs thereafter. Medicare-approved lab tests are free; you may have to pay a facility fee, though, which can amount to hundreds of dollars.

Alternatively, if you have Part A and undergo the transplant as a hospital inpatient, Medicare may cover the procedure. The Part A deductible will apply.

Can supplemental insurance help cover the cost of a cornea transplant?

It depends on the type of coverage you have.

• Medicare supplement insurance (Medigap) will help Medicare beneficiaries cover out-of-pocket costs for a cornea transplant.

• Supplemental policies by private insurers (such as accident or critical illness insurance) are unlikely to pay out for a cornea transplant. You’re better off relying on flexible spending account (FSA)  or health savings account (HSA) money for out-of-pocket costs.

• Stand-alone vision insurance doesn’t pay for medical procedures. The benefits of these policies are typically limited to discounts on corrective lenses, eye exams, and related services.

Nonprofits regularly chip in, too. The Cornea Research Foundation of America lists foundations and organizations that provide copay, prescription, and coinsurance support.

What type of aftercare is needed following a cornea transplant?

Because eyes are so delicate, you’ll want to stay as safe as possible after your transplant. Aftercare should include follow-up appointments with your doctor, the use of prescription eye drops to prevent tissue rejection, and extra rest to help the body heal.

According to the American Academy of Ophthalmology, transplant recovery should include these measures:

• Wearing an eye shield immediately post-surgery

• A next-day followup visit to the ophthalmologist, who assesses your condition and decides whether stitches will be removed

• Taking prescription eye drops to support healing

• Wearing glasses or other safety eyewear to help protect against injury

• Taking prescription pain medication as needed

• Following your doctor’s instructions — which may range from not rubbing your eyes and sleeping on your back, so the new cornea isn’t disturbed

What medications do you need to take after a cornea transplant?

After surgery, you may be prescribed topical or oral medications to help with pain, inflammation, and transplant rejection. Prescription drugs may include:

• Antibiotic eye drops

• Pain medications such as nonsteroidal anti-inflammatory drugs (NSAIDS)

• Corticosteroid, prednisolone, or other steroid eye drops 

• Immunosuppressants such as cyclosporine

What complications can arise from a cornea transplant?

While usually low-risk, cornea transplants have potential complications. Corneal rejection is one of the biggest. One 2022 study found that 18% to 21% of people experienced corneal tissue rejection after transplant.

Additional problems you may face after surgery include:

• Eye infection: Antibiotic drops can help you avoid infection.

• Pain: This can be a signal your body is rejecting the transplant, alongside:

• • Blurred vision

  • Light sensitivity

• Eye bleeding: This type of hemorrhage is caused by broken blood vessels in the eye.

• Glaucoma: This medical condition involves a damaged nerve at the back of the eye that can lead to vision loss or blindness. Ongoing use of the anti-rejection steroid medication prednisolone, for example, can cause glaucoma.

• Detached retina: When the retina — a layer of tissue at the back of the eye — pulls away from its normal place, it can cause a loss of eyesight. This needs immediate medical treatment.

Despite these potential problems, cornea transplantation remains among the most successful organ transplantation procedures. A new cornea is said to last up to 10 years or more. On the other hand, getting an artificial cornea can help avoid tissue rejection.

How long is the recovery process for a cornea transplant?

Recovery time after a cornea transplant can range from several months to a year, according to the National Keratoconus Foundation. 

A transplant that replaces the full cornea will take longer to heal than a partial transplant that replaces only some of the cornea’s six layers. Regardless, your doctor is likely to recommend wearing protective eyeglasses or an eye shield for several months.

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Written by:

Arnesa A. Howell

Arnesa A. Howell is an award-winning freelance writer, editor and content creator based in Washington, D.C., writing for national magazines and online outlets about health, social justice, entrepreneurship, lifestyle and culture, and more. A graduate of Howard University, Arnesa has served as board member and scholarship committee chair for the Journalism & Women Symposium, an advocacy organization for women journalists.

Edited by:

Caren Weiner, MSIS

Caren Weiner, MSIS, began her personal finance journalism career in 1986. She worked as a reporter for Money magazine and co-wrote its book-length “Guide to the 1986 Tax Reform Act.” From the beginning, she immersed herself in data on mutual fund total returns and marginal tax rates.

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