A cornea transplant, also called a keratoplasty, is a surgical procedure that replaces part of a diseased or injured cornea with healthy tissue from a carefully screened organ donor.
The traditional cornea transplant is called a penetrating or full-thickness transplantation and is still the most commonly performed procedure. It has a very high success rate for patients with diseases such as keratoconus or corneal scars from trauma or infection. The full-thickness transplant involves replacing a central portion of the cornea and stabilizing it with multiple sutures. These sutures may be selectively removed over the course of a year to improve vision by decreasing astigmatism, irregularities in the shape of the cornea.
Advances in surgical technique have led to the development of selective cornea transplants in which only the diseased portion of the cornea is removed. In these surgeries, either the front layers of the cornea are replaced, as in Deep Anterior Lamellar Keratoplasty (DALK), or the back layers of the cornea are replaced, as in Descemets Stripping Endothelial Keratoplasty (DSEK). Eyes with full-thickness abnormalities may not qualify for these newer techniques, but patients with Fuchs dystrophy and bullous keratopathy are usually excellent candidates for DSEK. The advantages of these techniques are that they result in faster visual recovery, improved structural integrity and, in some cases, a decreased risk of graft rejection.