Corneal Transplant (Keratoplasty)
Modern keratoplasty no longer always replaces the whole cornea. Today only the damaged layer can be replaced, which changes both recovery and the risk of rejection.
What it involves
A corneal transplant, or keratoplasty, consists of replacing corneal tissue when it has become clouded and there is no other way of restoring transparency.
Keratoplasty has advanced a great deal, and we can now replace only the part of the cornea that is clouded, rather than replacing it entirely as was done routinely in the past.
The three types
Anterior keratoplasty. The two front layers of the cornea are transplanted, keeping the patient's own inner layer.
Endothelial keratoplasty. Only the inner layer is transplanted. It is indicated when the problem lies in the endothelium, the layer responsible for keeping the cornea dehydrated and therefore transparent.
Penetrating keratoplasty. The full thickness of the cornea is transplanted. It is still necessary when the disease involves every layer.
How the decision is made
The choice depends on which layer is damaged, on the cause of the opacity and on the state of the rest of the eye. The preoperative assessment determines whether the patient is a candidate and which technique offers the best result in their particular case.
It is important to understand that the cornea is only one part of the optical system: if there is disease of the optic nerve or the retina, restoring corneal transparency will not on its own give vision back. That is why the preoperative assessment includes examination of the rest of the ocular structures.
Frequently asked questions
Why are there three types of transplant?
Because the cornea has layers with different functions and they are not always all damaged. If the problem is only the inner layer, replacing the whole cornea would be unnecessary. Replacing only the diseased tissue speeds up visual recovery and reduces the risk of rejection.
How long does vision take to recover?
It varies a great deal by technique. Lamellar keratoplasties usually recover sooner than penetrating keratoplasty, which can take months and require suture adjustments before the astigmatism settles. You will be given a realistic horizon for your case before surgery.
Is there a risk of rejection?
Yes, it is the most characteristic complication of this procedure, and that is why postoperative follow-up and the prescribed treatment are not optional. An episode of rejection caught in time can usually be reversed; one that is ignored may cost the graft.
Do you need care for corneal transplant?
Book online or call whichever practice is easiest for you.