Cornea Transplant

A Penetrating Keratoplasty (PK), or a full-thickness transplant, is when the entire cornea needs to be replaced. This procedure has the longest recovery compared to other transplant surgeries and it may take a year or even longer for vision to fully recover.

This same-day procedure takes between one and two hours and is offered within our Ambulatory Surgery Centers. Before surgery, you are given a light intravenous sedative and the eye is anesthetized. A circular device is placed over the cornea and used by the surgeon to remove a circular disc from your cornea. The donor graft is then placed and fastened to your eye with stitches.

You will be given antibiotic eye drops following surgery and an eye patch will be placed. You are typically allowed to go home after this procedure and will see your doctor the following day for the first post-operative appointment.

An eye patch and shield are used to protect the eye after surgery and are removed the next day at the post-operative appointment. This shield is used at night to protect the eye while you sleep and to prevent any accidental eye-rubbing. Most patients are asked to limit strenuous physical activities until healing has occurred. Subsequent clinic visits are scheduled to assess healing and remove the sutures.

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Your risk of complications and cornea rejection continues for years after your cornea transplant. For this reason, expect to see your eye doctor annually. Cornea rejection can often be managed with medications.

Once the outer layer of your cornea has healed, your eye doctor will work to make adjustments that can improve your vision, such as:

• Correcting unevenness in your cornea (astigmatism). The stitches that hold the donor cornea in place on your eye may cause dips and bumps in your cornea, making your vision blurry in spots. Your doctor may correct some of this by releasing a few stitches.
• Correcting vision problems. Refractive errors, such as nearsightedness and farsightedness can be corrected with glasses, contact lenses or in some cases, LASIK eye surgery.

Deep Anterior Lamellar Keratoplasty (DALK)

Although similar to a full-thickness PK procedure, a DALK (Deep Anterior Lamellar Keratoplasty) replaces only the top and middle layers of the cornea, leaving the very inner layer intact. As a result, the healing time and the risk of the body rejecting the cornea are decreased.

Endothelial Keratoplasty (DSEK, DSAEK & DMEK)

A DSEK procedure (Descemet’s Stripping Endothelial Keratoplasty) is a special type of transplantation, replacing just the back portion of the cornea with healthy donor tissue. The cornea has five layers and the deepest layer is delicate and can be damaged in diseases such as Fuchs Dystrophy, Pseudophakic Bullous Keratopathy (PBK), Aphakic Bullous Keratopathy (ABK), and Posterior Polymorphous Dystrophy (PPMD).

There are a few different kinds of Endothelial Keratoplasty, such as DSEK, DSAEK or DMEK. Your surgeon will review the options with you and make his or her recommendation at your evaluation.

During the procedure, the thin endothelial layer is removed from the rest of the cornea. The donor endothelium will be attached to a thin layer of donor cornea, then folded and inserted through a small incision. An air bubble is injected to push the donor cornea up against the posterior surface of your cornea. The pumping action of the new donor endothelium helps bond the donor tissue to your own cornea.

This procedure is an excellent alternative to a full-thickness transplant in certain patients that have a healthy cornea except for the back layer. Patients often experience a faster visual recovery, less astigmatism, and minimal stitches compared to a full-thickness transplant. In addition, this surgery can be combined with cataract surgery.

Like any corneal transplant procedure, there is still some risk of infection or rejection of the new donor tissue, so taking your medications properly and careful follow-up examinations are important.