The femtosecond laser is used to cut or trephine both the host and donor corneas resulting in a perfect sized graft. The profile of donor and host can be cut to enable interlocking along the interface allowing a ‘lock and key’ fit for greater interface stability. This can reduce the time until sutures can be removed thus speeding up recovery and may also reduce the level of astigmatism after the operation.

Following FS-DALK vision is poor in the first few days, then a slow improvement can be expected over several months after surgery, and the patient may notice small incremental improvements up to 12 months. Recovery may be a little quicker in FS-DALK compared to traditional DALK. Contact lenses or glasses may be used after about 3 months. Best vision may only be achieved after suture removal after 6-9 months.

Patients are started on a course of steroid and antibiotic drops. 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. 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 in eye clinics. Sutures are usually removed 9-18 months after surgery.

Elevated intraocular pressure – this occurs through severe pressure like pain in the 24 hours after your surgery which may be accompanied by loss of perception of light (everything is dark and you can’t see light shone on the eye). Loose suture / graft dehiscence happens occasionally when sutures 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. If your eye suddenly becomes red, painful or starts to have a sticky discharge after a period of getting better (in other word it suddenly gets worse), you should contact your doctor as this can be a sign of infection. 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 2 hours and is usually performed under general anaesthetic.