Indications and Types of Keratoplasty

Penetrating Keratoplasty: Procedure, Advantages, and Risks

Keratoplasty, commonly known as corneal transplantation, is a surgical procedure used to replace a damaged or diseased cornea with a donor cornea. There are several types of keratoplasty, including penetrating keratoplasty (PK), which involves full-thickness corneal replacement.

Indications for Keratoplasty

• Keratoconus: Progressive thinning and bulging of the cornea.
• Corneal scars due to trauma or infections.
• Fuchs’ endothelial dystrophy.
• Pseudophakic bullous keratopathy.
• Hereditary or acquired corneal diseases.

Procedure of Penetrating Keratoplasty

Penetrating keratoplasty is performed under local or general anesthesia. The damaged corneal tissue is surgically removed and replaced with a donor cornea, which is sutured into place. The sutures remain for several months to a year, allowing for proper healing and stabilization.

Advantages of Penetrating Keratoplasty

• Restores vision in cases of severe corneal opacity.
• Effective for full-thickness corneal pathology.
• Provides long-term visual rehabilitation.
• High success rate when performed by experienced surgeons.

Risks and Complications

• Graft rejection: The immune system may attack the transplanted cornea.
• Postoperative infection.
• Astigmatism due to sutures.
• Increased risk of glaucoma.
• Delayed healing and visual recovery.

Conclusion

Penetrating keratoplasty remains a crucial surgical intervention for patients with advanced corneal disease. Although it has potential complications, proper postoperative care and regular monitoring significantly enhance outcomes.