Penetrating Keratoplasty (Full-Thickness Corneal Transplant)

What PK involves

A circular button of the patient's full-thickness cornea is removed and replaced with a donor graft secured by very fine sutures. It is the oldest and most established form of corneal transplantation, and still the correct choice when scarring, thinning or perforation involves every layer.

When PK is preferred

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• Full-thickness corneal scars involving the endothelium
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• Advanced keratoconus after hydrops with Descemet's tears
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• Combined anterior and endothelial disease, or failed previous grafts
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• Certain infections or perforations requiring tectonic (structural) grafting
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Recovery and sutures

Healing is deliberately slow because the full-thickness wound must gain strength: sutures commonly remain for 12–18 months or longer and may be selectively removed to reduce astigmatism. Final visual rehabilitation — glasses or contact lenses — usually waits until the refraction stabilises.

Risks to understand

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• Endothelial rejection — the leading cause of late graft failure; RSVP symptoms need same-day attention
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• High or irregular astigmatism; glaucoma; infection; wound weakness — the eye remains more vulnerable to injury lifelong
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• Graft failure may require repeat transplantation
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Despite these cautions, PK restores useful sight to many eyes that have no alternative. The decision between PK, DALK and DSAEK is made by which layers are diseased — a key part of the preoperative consultation.

Information on this page is for general education and does not replace an examination, diagnosis or personalised medical advice from a qualified eye-care professional.

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