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 DALK / PK takes many months. 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. DALK corneal grafts have a lower risk of rejection due to the preservation of the host endothelial layer. The risk of graft rejection remains low with a penetrating keratoplasty. Vision may take several weeks to settle and patients often notice an incremental improvement over the first 6-12 months. Sutures are usually removed 12-18 months after surgery.

A number of concerns can arise following Femto PK, including: elevated intraocular pressure, loose suture / graft dehiscence and infection. You should contact your Laser Vision specialist if you experience any concerns following treatment.

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