Corneal Transplantation

What Is Corneal Transplantation?

Corneal transplantation, also known as keratoplasty, is a surgical procedure that replaces a damaged, scarred, or diseased cornea with healthy donor tissue. The cornea is the clear, dome-shaped surface at the front of the eye that helps focus light. When it becomes cloudy or irregular, vision is significantly impaired. Corneal transplantation restores transparency, improves vision, relieves pain, and enhances quality of life.

Conditions That May Require Corneal Transplant

Pseudophakic bullous keratopathy (Corneal oedema post cataract surgery)
Keratoconus (progressive thinning and bulging of the cornea)
Corneal scarring due to infections, injuries, or previous surgery
Fuchs’ endothelial dystrophy (corneal cell loss causing swelling and vision loss)
Corneal edema (persistent swelling not responsive to medication)
Thinning, perforation, or trauma-related corneal damage
Failed previous corneal transplant
Hereditary corneal disorders

Symptoms Indicating Need for Transplant

Blurred or cloudy vision not correctable with glasses or lenses
Severe eye pain from corneal swelling or surface irregularities
Glare, halos, or distortion of vision
Recurrent corneal infections
Vision loss impacting daily activities

Types of Corneal Transplantation

Modern corneal surgery is customized to the patient’s condition :

Penetrating Keratoplasty (PK)
Full-thickness corneal transplant, replacing all layers of the cornea.

Endothelial Keratoplasty (DSEK / DMEK)
Partial-thickness transplant replacing only the diseased innermost endothelial layer, leaving the rest of the cornea intact.

Deep Anterior Lamellar Keratoplasty (DALK)
Removes and replaces the front layers of the cornea while preserving the healthy endothelium.

Artificial Corneal Implants (Keratoprosthesis)
Used in rare cases where traditional transplantation is not possible.

Surgical Procedure

Detailed preoperative eye examination and corneal measurements
Selection of suitable donor corneal tissue from an eye bank
Local or general anesthesia depending on patient needs
Removal of the diseased portion of the cornea
Placement and suturing (or layering) of donor tissue
Application of protective eye shield and medications for healing

Risks & Complications

Although highly successful, corneal transplantation carries certain risks :

Graft rejection (immune response against donor tissue)
Infection
Astigmatism or irregular corneal shape
Recurrence of original disease in some cases
Detachment of graft layers (in partial transplants)
Glaucoma or increased eye pressure
Need for repeat transplant in rare cases

Postoperative Care & Recovery

Use of prescribed eye drops (antibiotics, steroids, lubricants)
Protective eyewear to avoid accidental injury
Avoidance of rubbing or pressing the eye
Regular follow-up visits to monitor healing and graft clarity
Stitches may remain for months; some are removed gradually
Vision recovery may take several months to stabilize
Long-term monitoring for signs of rejection (redness, pain, blurred vision, sensitivity to light)