Penetrating keratoplasty (PK) is a full thickness graft. The entire central cornea is removed and replaced with a donor cornea and sutured into place. PK is indicated if there is damage or pathology in the corneal endothelium as well as the more superficial stroma and epithelium. DALK is a partial thickness transplant and requires a healthy and clear endothelium.

Visual recovery after PK takes many months. Patients should be prepared to be patient. Typically, vision is poor in the first few days. Then slow improvement will be noticed for several months. After which it may stabilise. Good vision may then require glasses or contact lenses. At about 18 months after the operation further procedures such as laser surgery or lens implant procedure may be performed to obtain the best vision.

Patients are commenced on a topical steroid, antibiotic and lubricant. These drops are gradually reduced over 12 months. Some irritation, grittiness or aching of the eye is normal after DALK/PK. Severe pain is unusual. The eye can also feel itchy. It is important not to rub or touch the eye. Follow the instructions you were given regarding medication. Following a corneal transplant, patients are required to be careful / minimise any risk of trauma to the operated eye. They will require repeated regular attendance to Laser Vision. Although there is a risk of graft rejection it remains low with cases of routine penetrating keratoplasty. Sutures are usually removed 12-18 months after surgery.

Elevated intraocular pressure – if you experience severe pressure like pain in the 24 hours after your surgery you should contact your doctor or the hospital. Loose suture / graft dehiscence – occasionally sutures may come loose and require removal. This can be done easily under local anaesthetic in the clinic. Rarely it may be necessary to resuture the graft in the operating theatre. Infection – Generally, your eye should feel more and more comfortable with time after the surgery. If your eye suddenly becomes red, painful or starts to have a sticky discharge after a period of getting better (in other words it suddenly gets worse), you should contact your doctor. This can be a sign of infection which is rare. Allergies – occasionally occur with routine eye drops. If your eye or skin surrounding the eye becomes red and itchy after surgery let your doctor know.

Surgery takes around 60-90 minutes and is usually performed under local anaesthetic.