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Keratoplasty (Corneal Transplantation)

Surgical replacement of diseased or damaged corneal tissue with healthy donor cornea, including penetrating keratoplasty (full thickness), DALK (anterior lamellar), and DSAEK/DMEK (endothelial) techniques tailored to specific corneal pathology.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

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This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Göz Hastalıkları department. Book Appointment →

What is Keratoplasty (Corneal Transplantation)?

Keratoplasty refers to surgical replacement of diseased corneal tissue with healthy donor cornea procured from eye banks. Modern techniques have evolved from penetrating keratoplasty (PKP) to selective lamellar approaches replacing only diseased layers.

Penetrating keratoplasty (PKP) replaces all five corneal layers with full-thickness donor button. Deep anterior lamellar keratoplasty (DALK) replaces stroma preserving recipient Descemet membrane and endothelium for stromal pathologies (keratoconus, scarring).

Endothelial keratoplasty includes DSAEK (Descemet stripping automated endothelial keratoplasty) replacing posterior stroma plus Descemet/endothelium, and DMEK (Descemet membrane endothelial keratoplasty) selectively replacing only Descemet and endothelial cells for endothelial dysfunction (Fuchs dystrophy, bullous keratopathy).

Symptoms

Decreased visual acuity due to corneal disease
Corneal scarring from infection or trauma
Bullous keratopathy with painful epithelial bullae
Keratoconus with contact lens intolerance
Fuchs endothelial dystrophy with morning blur
Failed previous corneal graft
Chemical or thermal corneal burns

Risk Factors

Keratoconus (most common indication for PKP/DALK in young patients)
Fuchs endothelial dystrophy (leading indication for DMEK/DSAEK)
Pseudophakic bullous keratopathy
Corneal scarring from herpes simplex keratitis
Bacterial, fungal, or acanthamoeba keratitis
Previous corneal trauma or chemical injury
Corneal stromal dystrophies (lattice, granular, macular)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Visual acuity worse than 20/40 due to corneal opacity
  • Painful corneal edema unresponsive to medical therapy
  • Progressive keratoconus with worsening vision despite cross-linking
  • Corneal perforation or descemetocele
  • Failed corneal infection treatment requiring tectonic graft
  • Endothelial cell count <800 cells/mm² with corneal edema
  • Symptomatic bullous keratopathy after intraocular surgery

Treatment Methods

01
Comprehensive corneal evaluation: topography, OCT pachymetry, specular microscopy
02
Eye bank donor tissue procurement with specular microscopy and serology screening
03
PKP technique: trephination of recipient and donor cornea, suturing with 16-24 interrupted 10-0 nylon sutures
04
DALK technique: big-bubble technique with air injection separating stroma from Descemet, donor stromal disc suturing
05
DSAEK technique: Descemet stripping, insertion of pre-cut donor lenticule via Busin glide, air bubble tamponade
06
DMEK technique: Descemet membrane peeling, scrolled donor DMEK graft injection, unscrolling, air bubble fixation
07
Postoperative topical corticosteroids tapered over 6-12 months, antibiotics, lubricants
08
Suture removal selective at 6-18 months for PKP/DALK
09
Long-term immune rejection prophylaxis with topical steroids; systemic immunosuppression for high-risk grafts
10
Graft survival monitoring with serial endothelial cell counts and visual acuity

Which Department to Visit?

You can visit our Göz Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Göz Hastalıkları Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.