What Is a Corneal Transplant?

A corneal transplant ( also known as Keratoplasty ) replaces a damaged or distorted cornea with a healthy donor cornea. For keratoconus, this is usually considered when the cornea is too thin, irregular, or scarred and contact lenses or other treatments no longer provide adequate vision.

Why and When It’s Done

• When contact lenses or other treatments fail to give sufficient vision for daily activities.
• When the cornea has advanced thinning, bulging, or scarring.

The type of transplant depends on severity and corneal condition:

• DALK (Deep Anterior Lamellar Keratoplasty): Partial-thickness transplant preserving the inner corneal layer. Lower risk of rejection.
• PK (Penetrating Keratoplasty): Full-thickness transplant for more advanced scarring or thinning.

Success Rates

• DALK: Graft survival is approximately 96.7% at 10 years and 95.6% at 20 years for keratoconus patients¹.
• PK: Graft survival is approximately 90% at 5 years and 82% at 10 years².

Possible Risks and Complications

While most corneal transplants are successful, there are potential risks:

• Graft rejection: The immune system may attack the new cornea. Signs include redness, sensitivity to light, blurred vision, or pain.
• Infection: Rare but possible, especially in the early postoperative period.
• Astigmatism: The cornea may heal irregularly, sometimes requiring glasses, contact lenses, or additional procedures.
• Glaucoma: Raised eye pressure can occur after surgery.
• Suture-related problems: Stitches may loosen, break, or cause irritation.
• Failure of the graft: Occasionally, the transplanted cornea may become cloudy or fail to function, requiring repeat transplant.

Recovery and Follow-Up

• Follow-up appointments are critical, especially in the first year.
• Eye drops (steroids, antibiotics) are used to prevent infection and rejection.
• Avoid rubbing the eye and follow activity restrictions advised by your surgeon.
• Many patients gradually regain functional vision, though full vision may take 12–18 months.
• Although recovery takes months, many people can return to work within two weeks, depending on their job type.

Making the Decision

Deciding on a corneal transplant is individual and should be made with your eye care team. Consider:

• Stage of keratoconus and condition of your other eye.
• How much vision you need for work, driving, or daily life.
• Risks vs. benefits, and your willingness to follow postoperative care.

Key Message: Corneal transplants can restore vision when other treatments fail, but they require careful decision-making, strict follow-up, and realistic expectations about recovery and possible need for lenses afterward.