A Full-Thickness Corneal Transplant

Penetrating keratoplasty (PK) is a full-thickness corneal transplant used to restore vision in people with severe corneal diseases where glasses or contact lenses are no longer effective. This procedure replaces the central portion of the cornea with a healthy donor cornea, making it the best option when all layers of the cornea are damaged and cannot be treated with partial-thickness transplants.

Recovery and Healing: What to Expect

PK is major eye surgery, and healing is slow and gradual. Here’s what patients need to know:

Is the procedure painful?

  • The surgery itself is not painful, as it is performed under local or general anaesthesia.
  • Some mild discomfort, irritation, or foreign body sensation may occur after the operation but can be managed with medication.

How long does recovery take?

  • Healing takes time, and full vision improvement can take over a year.
  • Stitches remain in place for 18 to 24 months to stabilise the graft and reduce the risk of irregular astigmatism.
  • Regular check-ups are essential to monitor healing and detect potential complications like graft rejection or increased eye pressure (glaucoma).

Who Needs a Penetrating Keratoplasty?

PK is recommended for people with serious corneal diseases that significantly impair vision. Some of the most common indications include:

  1. Corneal Scarring
  • Scars from infections, injuries, or past surgeries that affect all layers of the cornea.
  • Scarring blocks light from passing through, leading to blurry or distorted vision.
  1. Advanced Keratoconus with Corneal Hydrops
  • A condition where the cornea thins and bulges outwards, distorting vision.
  • In severe cases, the inner corneal layer (Descemet’s membrane) ruptures, leading to fluid buildup (hydrops) and further vision impairment.
  1. Severe Chronic Bullous Keratopathy
  • Long-term swelling of the cornea due to endothelial cell failure, often following previous eye surgery.
  • If swelling leads to permanent scarring, a full-thickness transplant is necessary to restore vision.
  1. Corneal Perforations (Severe Eye Injuries)
  • A deep wound or hole in the cornea caused by trauma or infection.

PK is often performed urgently to restore structural integrity and prevent vision loss.

Key Benefits of PK

✔ Best option for full-thickness corneal damage – Ideal when all layers of the cornea are affected, and partial transplants are not possible.
✔ Well-established procedure – PK has been performed successfully for decades and is widely recognised in ophthalmology.
✔ Durable long-term results – Many PK grafts last for decades, significantly improving quality of life.

Things to Consider Before Surgery

❗ Long healing process – Because stitches stay in place for up to two years, vision takes longer to stabilise than in partial-thickness procedures.

❗ Higher risk of complications – PK carries a higher chance of graft rejection, infection, glaucoma, and astigmatism compared to newer, partial-thickness corneal transplants.

❗ Additional treatments may be needed – Some patients may require glasses, contact lenses, or laser surgery after the cornea has fully healed to achieve the best vision possible.

Is Penetrating Keratoplasty Right for You?

PK remains a gold standard for severe corneal disease where other treatments are not suitable. While newer techniques such as DALK and EK offer faster healing, PK remains the best choice when all corneal layers are damaged.

If you have been advised to undergo a corneal transplant, schedule a consultation to discuss your treatment options.