Corneal grafts or transplants are performed as a last resort when other options for Keratoconus either have not worked or are not suitable.
The best transplant option for those with keratoconus is a partial thickness corneal graft or a Deep Anterior Lamellar Keratoplasty (DALK). This preserves the patient’s own endothelial layer eliminating the possibility of blinding graft rejection.
Centre for Sight have developed a technique for performing DALK with highly precise femtosecond lasers. Where possible, this is the favoured option.
In the past, full thickness corneal transplants used to be performed for Keratoconus. The mean life of a full thickness graft (penetrating keratoplasty) is about 20 years. A DALK – Deep Anterior Lamellar Keratoplasty (partial thickness graft) is likely to survive for much longer as the back layer (endothelium) which belongs to the host/ patient is preserved. There is therefore no chance of blinding graft rejection. The DALK procedure requires considerable technical skill to obtain a good outcome. Lasers used for Lasik laser have been used by surgeons at Centre for Sight to make the procedure more precise and repeatable. Learn more about Femtosecond Laser DALK and watch an award-winning video of Centre for Sight surgery by clicking here.
Authored by Sheraz Daya MD FACP FACS FRCS(Ed) FRCOphth
Mr Daya is the Medical Director of Centre for Sight and listed amongst the 100 most influential ophthalmologists in the world (https://theophthalmologist.com/power-list/2018/sheraz-daya/).
Next review due August 2025.
