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Cornea + Keratoplastic Surgery


Keratoplasty, also known as corneal transplantation, is a surgical procedure in which a damaged or diseased cornea is replaced with a healthy one from a donor. 

The cornea is the clear outer layer at the front of the eye, and it plays a vital role in focusing light onto the retina to produce clear vision. When the cornea becomes damaged due to injury, disease, or other conditions, it can lead to vision problems and discomfort. 

The cornea also helps to protect the eye from dust, germs, and other harmful agents, and it is the eye’s first line of defense against injury. The cornea is made up of several layers of cells and tissues, and it is the only part of the eye that is transparent.

Keratoplasty can restore vision and relieve symptoms by replacing the damaged cornea with a healthy one.

Candidates for Keratoplasty Surgery

Keratoplasty or corneal transplantation may be recommended for people who have a damaged or diseased cornea that cannot be treated with other methods, such as medications or contact lenses. Some conditions that may require the surgery include:

  • Keratoconus, in which the cornea becomes thin and bulges outwards, causing distorted vision.
  • Fuchs’ Endothelial Dystrophy, a condition in which the innermost layer of cells in the cornea begins to fail, causing the cornea to swell and leading to cloudy vision.
  • Corneal scarring or injury from trauma, infections, or previous eye surgeries.
  • Corneal degeneration, such as in cases of lattice dystrophy or macular dystrophy.

The decision to undergo this surgery is made after a thorough eye examination and consultation with an ophthalmologist. The doctor evaluates the person’s eye condition and determines if keratoplasty is a suitable option.

How is Cornea Transplant Performed?

A cornea transplantation procedure can be performed using different techniques depending on the specific condition being treated and the preference of the surgeon. The two most common techniques are:

Penetrating keratoplasty (PK)

This technique involves removing the entire thickness of the damaged or diseased cornea and replacing it with a full-thickness cornea from a donor. The surgeon uses a circular cutting tool called a trephine to remove a circular button of the patient’s cornea, and then sutures the donor cornea into place using very fine sutures.

Endothelial keratoplasty (EK)

It is preferred for conditions that affect the innermost layer of the cornea, such as Fuchs’ endothelial dystrophy. It includes removing only the innermost layer of the patient’s cornea and replacing it with a donor graft that includes a healthy endothelial layer. EK can be further classified into Descemet’s stripping endothelial keratoplasty (DSEK) and Descemet’s membrane endothelial keratoplasty (DMEK), which differ in the thickness of the donor graft used.

After the procedure, the patient is closely monitored and may need to wear a protective eye patch for a period of time. The stitches used in PK are usually removed several months after the surgery, while EK may not require sutures at all. The success rate of cornea transplant surgery is generally high, but it may take several months for the vision to fully stabilize and improve.

Aftercare for Keratoplastic Surgery

In keratoplastic surgery’s aftercare period, patients should take special care of their eyes to promote proper healing and reduce the risk of complications. The ophthalmologist prescribes eye drops to use after the surgery. They help prevent infection and reduce inflammation. It’s vital to use them as instructed and not skip any doses.

Patients should avoid any strenuous activities or heavy lifting for several weeks after the surgery. This includes activities like sports, exercise, and bending over. It’s also crucial not to rub or touch the eye after the operation, as this can damage the cornea and stitches.

Following a healthy diet is essential for proper healing after keratoplasty. Patients should eat plenty of fruits, vegetables, and protein-rich foods. The candidates must attend several follow-up appointments with their ophthalmologist to monitor the recovery period. The doctor controls the patient’s vision and ensures that the new cornea is healing correctly.

Patients should not drive until their doctor has confirmed that their vision has returned to a safe level. If the person follows all instructions provided by the ophthalmologist after keratoplasty, there is a big chance to get the best possible results and reduce the risk of complications.


The recovery time for keratoplasty can vary depending on the individual and the extent of the surgery. It can take several weeks to several months for the eye to fully heal.

The vision improvement after keratoplasty can be long-lasting, but it can also depend on the individual case and the extent of the surgery. Regular examinations with the eye doctor are important to monitor the progress of the vision.

You may be able to wear contact lenses after keratoplastic surgery, but this depends on the individual case and the advice of your doctor.

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