Keratoplasty is the surgical removal of a scared cornea and transplantation of a donor cornea to treat corneal degeneration and dystrophies, opacities, scarring, injuries. Types of corneal grafts include penetrating, lamellar, keyhole lamellar.
Nursing diagnosis for keratoplasty: Anxiety related to threat to health status caused by possible loss of vision or transplant injection.
Expected Outcomes: Anxiety within manageable levels of evidenced by verbalizations that anxiety and fear reduced and feeling relaxed.
I. Assess for:
1. Level of anxiety, feelings about expectations of effect of graft.
Rationale: Anxiety ranges from mild to severe with moderate levels of expected with any surgery.
II. Perform or Provide:
1. Answers to any questions honestly and clearly
Rationale: Reduces anxiety and fear of unknown.
2. Quiet, supportive environment.
Rationale: Reduces anxiety and promotes relaxation.
Nursing diagnosis: Pain related to physical injuring agent caused by surgical graft procedure
Expected Outcomes: Absence of pain or discomfort evidenced by verbalizations that pain relieved by analgesic.
Nursing intervention with rationale:
I. Assess for:
1. Pain, scratchiness in eye, severity, and if increasing.
Rationale: Pain descriptors reveal need for analgesic and potential complications of surgery such as hemorrhage or glaucoma.
1. Mydriatic (atropine 1% eye drops).
Rationale: Decreases spasms of ciliary body to reduce pain.
2. Analgesic (aspirin, acetaminophen, codeine)
Rationale: Acts to relieve pain by interrupting CNS pathways.
III. Perform or Provide
1. Warm or cool compress to eye.
Rationale: Reduces lid and conjunctival edema and removes secretions.
2. Eye shield
Rationale: Prevents accidental rubbing or bumping of eye.