Vision For Life

Corneal transplant surgery

What is the cornea?

The cornea is the clear window at the front of the eye.
It is the part of the eye that performs most of the focusing of light for the eye.  

To have good vision, a transparent cornea with a smooth, regular shape is required.

What is a corneal transplant?

A corneal transplant is an operation in which your cornea is replaced with a cornea from a deceased person who has donated their cornea.

Why would I need a corneal transplant?

If a disease or injury affects the transparency or smoothness of the surface of the cornea, the quality of vision will be affected.
In such cases, a corneal transplant may be required to restore vision.

Are there different types of corneal transplants?

There are different types of corneal transplants.  The type of transplant required depends on the part of the corneal which is damaged.

If all layers of the cornea are affected, a penetrating keratoplasty is required.   If the back layer of the cornea (endothelium) is damaged, an endothelial transplant (such as a DMEK) is required.
If the front layer of the cornea (stroma) is damaged, a deep anterior lamellar keratoplasty is required.

Penetrating keratoplasty

A Penetrating Keratoplasty (PK) is a corneal transplant in which the full thickness of cornea is removed from the recipient and replaced with a new cornea from a donor.  This new transplant is  sutured (“stitched”) in place using very fine sutures so small they are very difficult to see with the naked eye.

Deep anterior lamellar keratoplasty

A Deep Anterior Lamellar Keratoplasty (DALK) is a corneal transplant in which the front 95% of your cornea is replaced with healthy cornea from a donor.  The transplant is.

The benefits of a DALK compared to a traditional full thickness corneal transplant (Penetrating Keratoplasty) are several

  • There is a significantly reduced risk of your immune system rejection your transplant
  • There is a lower risk of developing high pressure in the eye (glaucoma) in the weeks and months following surgery.
  • There is a lower risk of bleeding during the surgery

Descemet’s membrane endothelial keratoplasty (DMEK)

In some diseases, only the inside layer (endothelium) is affected, causing corneal oedema (swelling) and clouding.

DMEK is a modern type of corneal transplant operation in which the inside layer of your cornea (endothelium) is replaced with the inside layer from a donor cornea through a small incision (opening). 

The endothelium from the donor (transplant or graft) is inserted and pressed in position against the back of your cornea by a bubble of gas.

You can see a DMEK corneal transplant being performed here.