Penetrating Keratoplasty (PKP) or full thickness corneal transplant where all layers of the cornea are replaced with a clear healthy donor tissue which is secured in place with multiple sutures. A PKP requires a full year to heal. Attaining maximal visual recovery may still require a contact lens if the surface of the new cornea is irregular. Indefinite protection from eye injury is mandatory after a PKP.
Partial Thickness Corneal Transplant (DALK), also Known as Deep Anterior Lamellar Keratoplasty, replaces the front and middle section of the cornea while preserving the lining. It is an alternative to a full thickness graft. The advantages of DALK included reduced rejection rate, earlier return to unrestricted physical activity and shorter healing time. Reduced dependence on topical steroids (anti-rejection drops) after DALK creates less risk for steroid induces glaucoma and cataracts.
Endothelial Keratoplasty is a partial thickness transplant that replaces the damage innermost layer of the cornea (endothelium). There are two types of endothelial keratoplasty:
The type of endothelial keratoplasty procedure chosen by the surgeon depends on the corneal condition and anatomy.
The difference between a DSEK and DMEK is in the thickness of tissue transplanted and associated technical difficulty.
The advantages of endothelial keratoplasty:
DWEK (Descemet without Endothelial Keratoplasty), also known as DSO (Descemet Stripping Only), is a procedure where a small area of the lining of the cornea is removed to allow the patient’s own cells to regenerate without transplanting a donor tissue. It is offered to select Fuchs’ dystrophy patients.
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