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. 

Patients should be prepared for a relatively long recovery period after PK. Vision will be very blurred in the first week or two after DALK surgery. After this there is a slow improvement over a few months. But this will then stabilise. At this stage vision may improve considerably using glasses or contact lenses. To reduce the requirement of contact lenses and glasses further procedures including lens implant and laser surgery can be performed 18 months to 2 years after the transplant.

DALK aftercare involves patients taking steroid, antibiotic and lubricant drops. These drops are gradually reduced over 12 months. Often one drop a day of steroid is recommended for many years after the transplant to reduce the risk of rejection. Some irritation, grittiness or aching of the eye is normal after DALK. 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 to ensure a good recovery time. They will require repeated regular attendance in eye clinics. Sutures are usually removed 12-18 months after surgery.

Eye surgery comes with a degree of risk, and our Laser Vision specialists will ensure every step is taken to reduce the chance of adverse side effects. Potential complications can include: elevated intraocular pressure, loose suture / graft dehiscence, infection and allergies.

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