Corneal transplant, also known as penetrating keratoplasty, has a 90% success rate as defined by clear grafts in 1 year. The primary indication for the procedure is a hazy or opaque cornea causing decrease in vision. The etiologies of corneal opacities include congenital defects, hereditary dystrophies, infection, and trauma. Occasionally, corneal transplants are performed simultaneously with cataract surgery, intraocular lens exchange, or with posterior segment surgery, depending on other conditions affecting vision. The procedure is not as common as lamellar keratoplasty, in which only the anterior surface of the cornea is grafted, leaving the posterior surface intact.

For most patients, the operation is performed on an outpatient basis under local anesthesia with monitored anesthesia care. Under special circumstances, a patient may require general anesthesia and overnight stay in the hospital. Depending on whether or not other intraocular surgeries are performed at the same time, the operation lasts between one half to two hours and involves removing the patient's hazy cornea and replacing it with a clear donor cornea that is sewn in place with nylon sutures. It is performed under an operating microscope and requires the patient to lie still. When the operation is complete, the patient is given topical medications and the eye should be patched overnight. Blood loss is minimal to none during the procedure.

Usual postoperative course

Expected postoperative hospital stay

Most patients go home on the day of surgery.

Operative mortality

Extremely low and generally associated with the anesthetic used.