In situations where corneal damage is irreparable, corneal transplantation is the only way to restore vision. In a corneal transplant, we remove all of your damaged cornea and replace it with a healthy, donated cornea. There are several types of transplants:
- Penetrating keratoplasty (PK): Our surgeon removes a full-thickness section of the central part of your damaged cornea, replacing it with a healthy cornea using sutures. Sutures may stay in place for up to a year, sometimes longer. You will likely need specialty contact lenses to achieve your best possible vision.
- Deep anterior lamellar keratoplasty (DALK): Our surgeon removes the stroma, and replaces it with a healthy one. Sutures secure the cornea in place. The healing process is similar to a PK.
- Endothelial keratoplasty: Partial corneal transplant, performed when the endothelial cells (cells on the innermost layer of the cornea) are damaged or dysfunctional. There are two main types:
- Descemet membrane endothelial keratoplasty (DMEK): Your surgeon removes the layer between the stroma and endothelium, called the Descemet’s membrane as well as your endothelium. Your surgeon then replaces them with healthy donor tissue, The stroma remains untouched.
- Descemet-stripping automated endothelial keratoplasty (DSAEK): This is similar to DMEK, but your surgeon also removes a very small amount of your stroma and replaces it with a healthy section of stroma, Descemet’s membrane and endothelium.
Because transplants involve tissue from another patient, there is a risk of transplant rejection. Penetrating keratoplasty has the highest rate of rejection. Fortunately the rate is only 10 percent per year. Even if you have a rejection episode, most rejections can be treated medically as long as they are caught early. That’s why we will set up a thorough follow-up schedule with you.
In some cases, a corneal transplant is not possible. If you have had a failure of one or more corneal transplants, you may be a candidate for keratoprosthesis. A keratoprosthesis is an artificial cornea that can be used in some situations to restore vision.