Corneal Transplant Surgery
DMEK . DSO . DSAEK . DALK . PKP
Corneal transplantation is among the most complex and delicate surgical procedures in all of ophthalmology - and one of the most rewarding.
For patients whose corneas can no longer maintain clear, comfortable vision despite glasses or contact lenses, the correct type of transplant can help improve or restore vision.
At Lumiere Vision in Cremorne, corneal transplant surgery is performed by Dr Tanya Trinh - a fellowship-trained corneal surgeon whose training at the University of Toronto, co-directorship of Australia's only Keratoprosthesis Service at Sydney Eye Hospital, and more than 45 peer-reviewed publications place her among the most experienced corneal surgeons in the country.
She performs the full range of modern corneal transplant techniques.
This page explains each procedure clearly - what it involves, who it is for, what recovery looks like, and what risks to understand.
Click here to read directly about your suggested transplant type
DSO
Descemet Stripping Only
DSAEK
Descemet Stripping Automated Endothelial Keratoplasty
DALK
Deep Anterior Lamellar Keratoplasty
PKP
Penetrating Keratoplasty
DMEK
Descemet's Membrane Endothelial Keratoplasty
Understanding the Cornea
The five layers from front to back are: the epithelium (protective outer surface), Bowman's layer (thin structural layer), the stroma (the thick central layer making up 90% of corneal thickness), Descemet's membrane (a thin structural membrane), and the endothelium (a single layer of cells whose job is to pump fluid out and keep the cornea clear).
The cornea is the clear, dome-shaped front window of the eye. It has five distinct layers, each with a specific role. Modern corneal transplant surgery has advanced because techniques can now target just the diseased layer rather than replacing the entire cornea. Understanding which layer is affected by your condition determines which transplant technique is most appropriate.
When endothelial cells fail or are damaged - as in Fuchs dystrophy - fluid accumulates in the stroma, causing swelling and blur.
This can be addressed by partial thickness transplant types called DMEK (Descemet Membrane Endothelial Keratoplasty) or DSAEK (Descemet Stripping Endothelial Keratoplasty) or in select cases, corneal rejuvenation using techniques of Descemet Stripping Only or DWEK (Descemet Stripping Only or Descemet stripping Without Endothelial Keratoplasty).
When the front layers are very scarred or distorted - as in keratoconus or after infection – DALK (deep anterior lamellar keratoplasty) is appropriate. When the entire cornea is damaged, the full thickness corneal transplant – the Penetrating Keratoplasty is required.
Choosing the Right Procedure
Modern corneal surgery is precisely targeted. The era of replacing the entire cornea as the default approach is over for most conditions. The table below provides a plain-language summary to orientate you before reading the detail on each procedure.
Descemet's Membrane Endothelial Keratoplasty
What is replaced
Main condition
Recovery
Rejection risk
Inner 2 layers only (thinnest graft)
Fuchs dystrophy, endothelial failure
1 to 3 months
Lowest (~1 to 3%)
Descemet Stripping Only
Descemet Stripping Automated Endothelial Keratoplasty
Deep Anterior Lamellar Keratoplasty
Penetrating Keratoplasty
Nothing - own cells migrate in, does not replace a transplant but defers the need
Early and central Fuchs dystrophy only
Weeks to months
None (no donor)
Inner 2 layers + thin stroma
Fuchs dystrophy, bullous keratopathy, complex eyes
3 to 6 months
Low (~10 to 15%)
Front 90% (stroma + epithelium)
Keratoconus, anterior scarring
12 to 18 months
Low (back layers kept)
All 5 layers (full thickness)
Scarring, ectasia, failed grafts
12 to 18 months
Moderate (~15 to 25%)
Procedure
CRITICAL WARNING - No Flying After Descemet's Membrane Endothelial Keratoplasty or Descemet Stripping Automated Endothelial Keratoplasty
If you have had Descemet's Membrane Endothelial Keratoplasty or Descemet Stripping Automated Endothelial Keratoplasty surgery, you must not board any aircraft under any circumstances until your surgeon has confirmed that the air or gas bubble in your eye has fully absorbed.
Flying while an air or gas bubble is present causes the bubble to expand due to reduced cabin pressure. This pushes the transplant with force and can cause severe pain, graft failure, or blindness. This risk is life-altering and can be blinding.
Do not fly until specifically cleared by Dr Trinh - typically after two weeks, but varying by individual.
Choosing the Right Procedure
Modern corneal surgery is precisely targeted. The era of replacing the entire cornea as the default approach is over for most conditions. The table below provides a plain-language summary to orientate you before reading the detail on each procedure.
DMEK
Procedure type
What is replaced
Inner 2 layers only (thinnest graft)
Main condition
Fuchs dystrophy, endothelial failure
Recovery
1 to 3 months
Rejection risk
Lowest (~1 to 3%)
DSO
Procedure type
What is replaced
Nothing - own cells migrate in, does not replace a transplant but defers the need
Main condition
Early and central Fuchs dystrophy only
Recovery
Weeks to months
Rejection risk
None (no donor)
DSAEK
Procedure type
What is replaced
Inner 2 layers + thin stroma
Main condition
Fuchs dystrophy, bullous keratopathy, complex eyes
Recovery
3 to 6 months
Rejection risk
Low (~10 to 15%)
DALK
Procedure type
What is replaced
Front 90% (stroma + epithelium)
Main condition
Keratoconus, anterior scarring
Recovery
12 to 18 months
Rejection risk
Low (back layers kept)
PKP
Procedure type
What is replaced
All 5 layers (full thickness)
Main condition
Scarring, ectasia, failed grafts
Recovery
12 to 18 months
Rejection risk
Moderate (~15 to 25%)
CRITICAL WARNING - No Flying After DMEK or DSAEK
If you have had DMEK or DSAEK surgery, you must not board any aircraft under any circumstances until your surgeon has confirmed that the air or gas bubble in your eye has fully absorbed.
Flying while an air or gas bubble is present causes the bubble to expand due to reduced cabin pressure. This pushes the transplant with force and can cause severe pain, graft failure, or blindness. This risk is life-altering and can be blinding.
Do not fly until specifically cleared by Dr Trinh - typically after two weeks, but varying by individual.
DMEK - Descemet's Membrane Endothelial Keratoplasty
The gold standard for Fuchs dystrophy and endothelial failure.
Descemet's Membrane Endothelial Keratoplasty is the most advanced corneal transplant technique
currently available for diseases of the inner corneal layer.
It is now the global gold standard treatment for Fuchs endothelial corneal dystrophy, having rapidly replaced
Descemet Stripping Automated Endothelial Keratoplasty due to superior visual outcomes and a lower rejection rate.
It does however require an experienced surgeon to execute the technique well.
What Descemet's Membrane Endothelial Keratoplasty replaces:
What conditions Descemet's Membrane Endothelial Keratoplasty treats:
- Fuchs endothelial corneal dystrophy - the most common indication.
- Bullous keratopathy - endothelial failure following previous cataract surgery or intraocular procedures (where the endothelium has “worn out” more rapidly than natural ageing changes).
- Failed Descemet Stripping Automated Endothelial Keratoplasty graft in suitable cases.
- Other causes of endothelial failure where the stroma is healthy.
Think of it this way: the donor graft is like a thin sheet of paper, and the air bubble is like a helium balloon pressing it against the ceiling - the back of your cornea.
If you sit upright, the bubble moves away from the graft and the graft detaches.
For the first 48 to 72 hours: lie flat on your back, nose pointed at the ceiling.
Only toilet and essential meal breaks are permitted. You will have a fifteen minute break every hour.
You will need someone with you at home. You cannot drive yourself home from hospital - you must lie flat in the passenger seat on the journey home.
And for the first few weeks after surgery, you may require extra supportive bubbles to help the eye accept the transplant, which may require the 48-72 hour back rest period at each rebubbling instance.
Recovery:
- Vision often begins to improve within 4-8 weeks as the graft settles and corneal swelling reduces.
- Full visual recovery typically occurs after 3 months after successful attachment.
- Do not obtain new glasses until your surgeon advises - the prescription fluctuates rapidly during healing.
- Anti-rejection steroid eye drops continue for about 2 years, in which case many patients may come off eyedrops altogether; some special conditions will require indefinite eyedrop therapy to prevent the body from rejecting the transplant.
- Graft detachment requiring re-bubbling (a subsequent injection of air) occurs in approximately 10 to 15% of cases - a well-recognised, expected and manageable part of postoperative care.
Why Descemet's Membrane Endothelial Keratoplasty is superior to older techniques (for otherwise normal eyes)
or Penetrating Keratoplasty.
The rejection rate is approximately 1 to 3% - significantly lower than either Descemet Stripping Automated Endothelial Keratoplasty or Penetrating Keratoplasty.
For eyes that have a complicated history – prior surgeries or eye conditions that limit vision – the choice of transplant may be better served by a Descemet Stripping Automated Endothelial Keratoplasty than a Descemet's Membrane Endothelial Keratoplasty so that the chances of attachment and acceptance is higher.
Risks specific to Descemet's Membrane Endothelial Keratoplasty
- Graft detachment requiring re-bubbling - the most common complication (~10 to 15%).
- Transplant rejection - uncommon (~1 to 3%) but possible at any point in life.
- Cataract formation - long-term steroid drops can accelerate cataract development.
- Elevated eye pressure (glaucoma) - up to 30% of patients on long-term steroid drops; monitored at every follow-up.
- Transplant failure - rare but possible.
- Loss of vision or the eye (rare).
- Immune reaction causing loss of vision in the other eye (extremely rare).
Who is suitable for Descemet Stripping Only :
Descemet Stripping Only is only suitable for patients with early to moderate Fuchs dystrophy who meet strict criteria.
The peripheral endothelium must be sufficiently healthy to support central migration.
Descemet Stripping Only is not appropriate for advanced disease.
The decision requires careful specialist imaging of endothelial cell density and distribution by confocal microscopy.
Dr Trinh will advise whether Descemet Stripping Only is appropriate for your specific stage of disease after the appropriate investigations and an examination of your eye.
DSO - Descemet Stripping Only (Descemetorhexis Without Endothelial Keratoplasty)
A donor-free option for carefully selected early Fuchs dystrophy - pioneered at Sydney Eye Hospital.
Descemet Stripping Only - also known as DWEK (Descemetorhexis Without Endothelial Keratoplasty) - involves no donor tissue at all.
The thinnest back layer (consisting of the diseased Descemet's membrane and endothelium, only 50um thick!) are removed from the centre of the cornea, and the eye's own peripheral endothelial cells - which remain healthy in early Fuchs dystrophy - migrate inward over weeks to months to repopulate the cleared area.
Descemet Stripping Only was among the techniques pioneered and published by Dr Gregory Moloney at Sydney Eye Hospital - a foundational clinical contribution that has influenced global corneal surgery practice.
Dr Tanya Trinh, who was selected to succeed Dr Moloney at Sydney Eye Hospital, continues to offer Descemet Stripping Only to appropriately selected patients.
Recovery:
- Vision dramatically worsens initially (from the first day) as the cornea swells following removal of the diseased layer.
- Clearance and visual improvement usually begin within 3 to 6 weeks as cells migrate inward.
- Full recovery can take several months.
- Rho-kinase (ROCK) inhibitor eye drops are typically prescribed to stimulate endothelial cell migration - an important part of the protocol.
- No anti-rejection drops are required long term as there is no foreign tissue.
How long do Descemet Stripping Only results last:
A 2024 study in the journal Cornea following patients for 5 or more years found approximately 77% maintained clear central corneas at 5 years.
A 2025 case report of one patient (Moayed et al.) described successful 10-year outcomes following bilateral Descemet Stripping Only , though the right eye eventually required Descemet's Membrane Endothelial Keratoplasty 10 years after the initial procedure as Fuchs disease continued to progress.
The evidence suggests Descemet Stripping Only can provide excellent vision for many years in suitable patients, with Descemet's Membrane Endothelial Keratoplasty remaining a viable rescue option if Descemet Stripping Only eventually fails.
Remember, the Descemet's Membrane Endothelial Keratoplasty transplant is still the gold standard treatment worldwide for Fuchs Endothelial Dystrophy with excellent outcomes.
Risks specific to Descemet Stripping Only :
- Failure to repopulate - peripheral cells may not successfully migrate to the centre, requiring Descemet's Membrane Endothelial Keratoplasty as a rescue procedure (approximately 20 to 25% of cases).
- Longer and less predictable recovery than Descemet's Membrane Endothelial Keratoplasty.
- Dramatic initially poor vision (hence only being performed one eye at a time).
- Not suitable for advanced disease.
- Long-term durability still being established - ongoing follow-up is important.
- Loss of vision or the eye (rare).
- Immune reaction causing loss of vision in the other eye (extremely rare).
What Descemet's Membrane Endothelial Keratoplasty replaces:
Descemet Stripping Automated Endothelial Keratoplasty transplants Descemet's membrane and the endothelium along with a thin layer of donor stromal tissue - typically 100 to 150 microns. This additional stromal layer makes the graft more robust than Descemet's Membrane Endothelial Keratoplasty, which is an advantage in complex cases, but creates a tissue interface within the visual axis that modestly limits maximum visual acuity.
DSAEK - Descemet Stripping Automated Endothelial Keratoplasty
A well-established posterior endothelial transplant for cases not suitable for Descemet's Membrane Endothelial Keratoplasty.
Descemet Stripping Automated Endothelial Keratoplasty (a partial thickness transplant involving the inner layers of the eye) was the procedure that revolutionised endothelial corneal disease treatment in the early 2000s, replacing the full thickness transplant (penetrating keratoplasty) for most endothelial conditions.
It has now largely been superseded by Descemet's Membrane Endothelial Keratoplasty for straightforward Fuchs dystrophy, but Descemet Stripping Automated Endothelial Keratoplasty remains essential for cases where Descemet's Membrane Endothelial Keratoplasty is technically unsuitable - including eyes with prior glaucoma surgery, iris abnormalities, a missing lens, or complex anatomy that makes the ultra-thin Descemet's Membrane Endothelial Keratoplasty graft difficult to handle.
Recovery:
- Vision begins to improve within 4 to 6 weeks as the graft adheres and corneal swelling reduces.
- Full visual stabilisation typically occurs over 3 to 6 months.
- Visual acuity is typically slightly less sharp than Descemet's Membrane Endothelial Keratoplasty due to having an additional layer of tissue to see through.
- Anti-rejection steroid drops continue long-term; some patients are able to come off drops entirely.
Risks specific to Descemet Stripping Automated Endothelial Keratoplasty:
- Graft detachment requiring re-bubbling - less common than Descemet's Membrane Endothelial Keratoplasty (~5 to 10%).
- Transplant rejection - approximately 10 to 15% over 5 years.
- Residual interface haze - may modestly limit maximum vision.
- Elevated eye pressure (glaucoma) – must be monitored due to long-term steroid use; severe glaucoma is sight threatening.
- Cataract formation - associated with long-term steroid use but very treatable.
- Loss of vision or the eye (rare).
- Immune reaction causing loss of vision in the other eye (extremely rare).
What conditions Descemet Stripping Automated Endothelial Keratoplasty treats:
- Fuchs endothelial corneal dystrophy - where Descemet's Membrane Endothelial Keratoplasty is technically unsuitable.
- Bullous keratopathy (Decompensated cornea) following prior cataract surgery or intraocular procedures.
- Eyes with glaucoma drainage tubes, iris defects, or aphakia.
- Endothelial failure in anatomically complex eyes.
LYING FLAT - Also Essential After Descemet Stripping Automated Endothelial Keratoplasty
The lying flat requirement applies equally to Descemet Stripping Automated Endothelial Keratoplasty. You must lie flat on your back for 48 to 72 hours after Descemet Stripping Automated Endothelial Keratoplasty surgery to allow the transplant to adhere and be accepted by the eye.
There is a fifteen minute break every hour to allow for movement and being upright – during this time you may stretch your legs, go for a walk, use the bathroom or shower, and have your meals. You cannot drive yourself home from hospital - you must lie flat in the front passenger seat.
The no-flying restriction also applies: do not board any aircraft until specifically cleared by Dr Trinh, typically after two weeks.
DALK - Deep Anterior Lamellar Keratoplasty
An anterior partial-thickness transplant for keratoconus and anterior corneal scarring.
Deep Anterior Lamellar Keratoplasty is a partial-thickness anterior corneal transplant that replaces the front 90% of the cornea - the epithelium, Bowman's layer, and the stroma - while preserving the patient's own Descemet's membrane and endothelium.
By retaining these back two layers, Deep Anterior Lamellar Keratoplasty eliminates endothelial rejection risk and offers a lower long-term rejection rate compared to full-thickness Penetrating Keratoplasty.
The procedure:
Deep Anterior Lamellar Keratoplasty is technically the most demanding of the corneal transplant procedures. It requires an overnight hospital stay under a local anaesthetic with sedation.
The surgeon must carefully separate the anterior host corneal stroma from the underlying Descemet's membrane - a step requiring advanced surgical skill and carrying a moderate risk of requiring conversion to Penetrating Keratoplasty if the membrane tears. Dr Trinh will discuss this possibility clearly at your consultation and will inform you if conversion was required when you wake after surgery.
Fine sutures are placed around the transplant and remain for approximately 9 to 12 months, removed gradually in stages according to corneal surface measurements at successive appointments.
Recovery:
- Vision is blurry initially - useful vision does not return for several weeks.
- Overall recovery timeline is 12 to 18 months as sutures are gradually removed and the eye stabilises.
- Once all sutures are removed, glasses or contact lenses are typically required to refine vision; some cases may be amenable to rehabilitative laser, implantable collamer lenses or cataract surgery to further improve vision.
- Anti-rejection steroid drops continue throughout the suture removal period and often for a further year, in many cases indefinitely.
What conditions Deep Anterior Lamellar Keratoplasty treats:
- Keratoconus - the most common indication - when contact lenses and glasses can no longer adequately correct vision.
- Corneal warpage - abnormal bulging and thinning of the corneal stroma.
- Anterior corneal scarring from infection, trauma, or previous surgery.
- Corneal stromal dystrophies affecting the front layers.
Why Deep Anterior Lamellar Keratoplasty is preferred, where possible, over Penetrating Keratoplasty for keratoconus:
Risks specific to Deep Anterior Lamellar Keratoplasty:
- Intraoperative perforation of Descemet's membrane requiring conversion to Penetrating Keratoplasty - approximately 5 to 10% of cases, higher where the posterior layers have had damage before and are therefore weakened.
- Interface haze or scarring between donor and host stroma.
- Elevated eye pressure (glaucoma) - up to 30% of patients on long-term steroid drops.
- Cataract formation.
- Transplant rejection of the anterior graft - less common than Penetrating Keratoplasty but possible.
- Loss of vision or the eye (rare).
- Immune reaction causing loss of vision in the other eye (extremely rare).
PKP - Penetrating Keratoplasty
Full-thickness corneal transplant - the original technique and still essential for complex cases.
Penetrating keratoplasty - PKP, also called PK - is a full-thickness corneal transplant in which all five layers of the patient's cornea are replaced with donor tissue - think of it like a cookie cutter approach. It was the first successful corneal transplant procedure, performed by Eduard Zirm in 1905. While largely replaced for specific conditions by targeted lamellar procedures, Penetrating Keratoplasty remains an essential technique where the entire cornea is affected.
What conditions require Penetrating Keratoplasty:
- Full-thickness corneal scarring from infection, severe trauma, or previous surgery.
- Advanced corneal disease involving multiple layers that cannot be addressed with partial-thickness techniques.
- Corneal perforation - where Penetrating Keratoplasty is used urgently to close the eye and save it from loss.
- Failed previous corneal grafts in selected cases.
- Conditions affecting both anterior and posterior cornea simultaneously.
The procedure:
Sutures remain for 9 to 12 months and are removed gradually. The suture removal process guides the final corneal shape and manages induced astigmatism, which is more common following PKP than lamellar techniques.
Recovery:
- Vision is blurry for many months as the eye heals and sutures are managed.
- Overall recovery is 12 to 18 months from surgery to final visual stabilisation.
- Glasses or contact lenses are typically required to refine vision after all sutures are removed.
- Anti-rejection steroid drops are required indefinitely in most cases.
The long-term picture:
Why the eye is weaker after Penetrating keratoplasty :
Risks specific to Penetrating keratoplasty :
- Transplant rejection - approximately 15 to 25% over 5 years.
- Significant induced astigmatism requiring glasses or contact lenses.
- Wound dehiscence following trauma.
- Intraoperative haemorrhage during the open-sky phase (rare).
- Cataract formation.
- Elevated eye pressure or glaucoma (up to 30% of patients on long-term steroids).
- Retinal detachment (rare).
- Loss of vision or the eye (rare).
- Immune reaction causing loss of vision in the other eye (extremely rare).
Transplant Rejection - Recognising the Warning Signs
R.S.V.P - Know These Four Warning Signs
Redness - increased redness of the transplanted eye.
Sensitivity - increased light sensitivity.
Vision - decreased or worsening vision.
Pain - new or worsening eye pain.
If you notice any combination of these symptoms after a corneal transplant, contact Lumiere Vision immediately. Do not wait for your next scheduled appointment. Rejection caught early and treated with intensive steroid drops can often be reversed. Untreated rejection leads to graft failure.
This is why anti-rejection drops must be continued as directed and why lifelong follow-up is essential. Rejection does not mean the transplant has failed - early treatment saves most grafts.
Donor Tissue - Where Does It Come From?
Tissue availability varies and can occasionally affect the timing of elective transplant surgery. In emergency situations such as corneal perforation, surgery proceeds as soon as suitable tissue is available. Dr Trinh will discuss expected wait times at your consultation.
Why Choose Lumiere Vision for Corneal Transplant Surgery?
At Lumiere Vision, every corneal transplant patient receives a comprehensive consultation, thorough explanation of which technique is recommended and why, and detailed written and verbal information about their procedure, risks, and recovery.
Surgery and all follow-up appointments are conducted personally by Dr Trinh.
Frequently Asked Questions
Will I always need glasses after a corneal transplant?
How do I rehabilitate the vision after a corneal transplant?
Is corneal transplant surgery covered by Medicare?
How long does a corneal transplant last?
Who does my donor cornea come from?
Will I always need eye drops after a corneal transplant surgery?
Can I have cataract surgery at the same time?
What is the difference between rejection and failure?
How long will I be in hospital?
What do I do with showering after a transplant?
When can I resume full exercise after a transplant?
When can I resume wearing makeup after a transplant?
What happens during vaccinations?
When are stitches (sutures) removed after a corneal transplant?
Can the stitches (sutures) break themselves after a corneal transplant?
Will I always need glasses after a corneal transplant?
How do I rehabilitate the vision after a corneal transplant?
Is corneal transplant surgery covered by Medicare?
How long does a corneal transplant last?
Who does my donor cornea come from?
Will I always need eye drops after a corneal transplant surgery?
Can I have cataract surgery at the same time?
What is the difference between rejection and failure?
How long will I be in hospital?
What do I do with showering after a transplant?
When can I resume full exercise after a transplant?
When can I resume wearing makeup after a transplant?
What happens during vaccinations?
When are stitches (sutures) removed after a corneal transplant?
Can the stitches (sutures) break themselves after a corneal transplant?
In many cases or an otherwise virgin eye without co-mordbities, more than 30 years. Graft survival depends on the technique used, the underlying condition, the patient's immune response, and lifelong adherence to anti-rejection drops and follow-up. Descemet's Membrane Endothelial Keratoplasty has the highest 5-year graft survival of current techniques.
Will I always need glasses after a corneal transplant?
How do I rehabilitate the vision after a corneal transplant?
Is corneal transplant surgery covered by Medicare?
How long does a corneal transplant last?
Who does my donor cornea come from?
Will I always need eye drops after a corneal transplant surgery?
Can I have cataract surgery at the same time?
What is the difference between rejection and failure?
How long will I be in hospital?
What do I do with showering after a transplant?
When can I resume full exercise after a transplant?
When can I resume wearing makeup after a transplant?
What happens during vaccinations?
When are stitches (sutures) removed after a corneal transplant?
Can the stitches (sutures) break themselves after a corneal transplant?
We are very lucky to have an excellent eyebank at the New South Wales Eye Bank who supplies all of the cornea transplants for New South Wales based surgeons. Transplants come from Australian locals who have so generously given of their body after their passing. Very occasionally we will receive tissue from interstate, but never from overseas.
Will I always need glasses after a corneal transplant?
How do I rehabilitate the vision after a corneal transplant?
Is corneal transplant surgery covered by Medicare?
How long does a corneal transplant last?
Who does my donor cornea come from?
Will I always need eye drops after a corneal transplant surgery?
Can I have cataract surgery at the same time?
What is the difference between rejection and failure?
How long will I be in hospital?
What do I do with showering after a transplant?
When can I resume full exercise after a transplant?
When can I resume wearing makeup after a transplant?
What happens during vaccinations?
When are stitches (sutures) removed after a corneal transplant?
Can the stitches (sutures) break themselves after a corneal transplant?
Most patients require glasses or contact lenses to achieve their best vision after corneal transplantation, particularly after Deep Anterior Lamellar Keratoplasty and Penetrating Keratoplasty where sutures introduce astigmatism. With Descemet's Membrane Endothelial Keratoplasty and Descemet Stripping Automated Endothelial Keratoplasty, many patients achieve excellent vision, though glasses are still common to “fine tune” the final vision.
Will I always need glasses after a corneal transplant?
How do I rehabilitate the vision after a corneal transplant?
Is corneal transplant surgery covered by Medicare?
How long does a corneal transplant last?
Who does my donor cornea come from?
Will I always need eye drops after a corneal transplant surgery?
Can I have cataract surgery at the same time?
What is the difference between rejection and failure?
How long will I be in hospital?
What do I do with showering after a transplant?
When can I resume full exercise after a transplant?
When can I resume wearing makeup after a transplant?
What happens during vaccinations?
When are stitches (sutures) removed after a corneal transplant?
Can the stitches (sutures) break themselves after a corneal transplant?
Visual rehabilitation will depend on the transplant type and the co-morbidities that your eye has at the time of surgery. Visual rehabilitation may include glasses, contact lenses, rehabilitative laser in select cases, implantable collamer lenses, piggyback lenses and cataract surgery. Dr Trinh will advise on your options as there is often several methods to consider when rehabilitating vision after a corneal transplant.
Will I always need glasses after a corneal transplant?
How do I rehabilitate the vision after a corneal transplant?
Is corneal transplant surgery covered by Medicare?
How long does a corneal transplant last?
Who does my donor cornea come from?
Will I always need eye drops after a corneal transplant surgery?
Can I have cataract surgery at the same time?
What is the difference between rejection and failure?
How long will I be in hospital?
What do I do with showering after a transplant?
When can I resume full exercise after a transplant?
When can I resume wearing makeup after a transplant?
What happens during vaccinations?
When are stitches (sutures) removed after a corneal transplant?
Can the stitches (sutures) break themselves after a corneal transplant?
Some transplant types will get away with having no drops after a year or two, but some transplant types will always need some sort of immunosuppressive drop to prevent the body from rejecting the transplant. Generally it is rare to require oral medications to manage rejection. Having anti-rejection topical eye drop medications on a regular basis means being monitored for side effects every 6 months at a minimum.
Will I always need glasses after a corneal transplant?
How do I rehabilitate the vision after a corneal transplant?
Is corneal transplant surgery covered by Medicare?
How long does a corneal transplant last?
Who does my donor cornea come from?
Will I always need eye drops after a corneal transplant surgery?
Can I have cataract surgery at the same time?
What is the difference between rejection and failure?
How long will I be in hospital?
What do I do with showering after a transplant?
When can I resume full exercise after a transplant?
When can I resume wearing makeup after a transplant?
What happens during vaccinations?
When are stitches (sutures) removed after a corneal transplant?
Can the stitches (sutures) break themselves after a corneal transplant?
Yes. For patients with both Fuchs dystrophy and cataracts, a “combined triple” meaning a corneal transplant surgery (usually a Descemet's Membrane Endothelial Keratoplasty ) combined with cataract extraction and implantation of a lens is a not-infrequently the preferred approach. This avoids two separate procedures and allows recovery from both simultaneously. Dr Trinh will discuss this at your consultation.
Will I always need glasses after a corneal transplant?
How do I rehabilitate the vision after a corneal transplant?
Is corneal transplant surgery covered by Medicare?
How long does a corneal transplant last?
Who does my donor cornea come from?
Will I always need eye drops after a corneal transplant surgery?
Can I have cataract surgery at the same time?
What is the difference between rejection and failure?
How long will I be in hospital?
What do I do with showering after a transplant?
When can I resume full exercise after a transplant?
When can I resume wearing makeup after a transplant?
What happens during vaccinations?
When are stitches (sutures) removed after a corneal transplant?
Can the stitches (sutures) break themselves after a corneal transplant?
Rejection is an immune reaction that, when caught early, can usually be reversed with prompt treatment. Failure means the graft has permanently lost function (unable to maintain its own clarity) and cannot be reversed without repeat transplantation.
Untreated rejection leads to failure.
This distinction underlines the importance of knowing the R.S.V.P. warning signs and acting on them immediately.
Will I always need glasses after a corneal transplant?
How do I rehabilitate the vision after a corneal transplant?
Is corneal transplant surgery covered by Medicare?
How long does a corneal transplant last?
Who does my donor cornea come from?
Will I always need eye drops after a corneal transplant surgery?
Can I have cataract surgery at the same time?
What is the difference between rejection and failure?
How long will I be in hospital?
What do I do with showering after a transplant?
When can I resume full exercise after a transplant?
When can I resume wearing makeup after a transplant?
What happens during vaccinations?
When are stitches (sutures) removed after a corneal transplant?
Can the stitches (sutures) break themselves after a corneal transplant?
Yes. Corneal transplant surgery attracts a Medicare rebate and is typically covered by private health insurance for patients with appropriate hospital cover. Because these are medically necessary procedures, cover is usually fairly comprehensive. Out-of-pocket costs depend on your health fund and cover level. Dr Trinh will provide a full cost breakdown at consultation.
Will I always need glasses after a corneal transplant?
How do I rehabilitate the vision after a corneal transplant?
Is corneal transplant surgery covered by Medicare?
How long does a corneal transplant last?
Who does my donor cornea come from?
Will I always need eye drops after a corneal transplant surgery?
Can I have cataract surgery at the same time?
What is the difference between rejection and failure?
How long will I be in hospital?
What do I do with showering after a transplant?
When can I resume full exercise after a transplant?
When can I resume wearing makeup after a transplant?
What happens during vaccinations?
When are stitches (sutures) removed after a corneal transplant?
Can the stitches (sutures) break themselves after a corneal transplant?
All corneal transplant procedures at Lumiere Vision require one overnight hospital stay. For DMEK and DSAEK, the overnight stay is essential because the lying flat requirement must begin immediately from the time of surgery. Dr Trinh reviews you the following morning before you are discharged.
Will I always need glasses after a corneal transplant?
How do I rehabilitate the vision after a corneal transplant?
Is corneal transplant surgery covered by Medicare?
How long does a corneal transplant last?
Who does my donor cornea come from?
Will I always need eye drops after a corneal transplant surgery?
Can I have cataract surgery at the same time?
What is the difference between rejection and failure?
How long will I be in hospital?
What do I do with showering after a transplant?
When can I resume full exercise after a transplant?
When can I resume wearing makeup after a transplant?
What happens during vaccinations?
When are stitches (sutures) removed after a corneal transplant?
Can the stitches (sutures) break themselves after a corneal transplant?
Patients should shower and wash their hair the morning of or the night before surgery. The eye should be kept dry (free of exposure to free water) for a week. You may choose to use dry shampoo or wash your hair “hairdresser style” with someone assisting you as you lie on your back with the water running away from the face.
Will I always need glasses after a corneal transplant?
How do I rehabilitate the vision after a corneal transplant?
Is corneal transplant surgery covered by Medicare?
How long does a corneal transplant last?
Who does my donor cornea come from?
Will I always need eye drops after a corneal transplant surgery?
Can I have cataract surgery at the same time?
What is the difference between rejection and failure?
How long will I be in hospital?
What do I do with showering after a transplant?
When can I resume full exercise after a transplant?
When can I resume wearing makeup after a transplant?
What happens during vaccinations?
When are stitches (sutures) removed after a corneal transplant?
Can the stitches (sutures) break themselves after a corneal transplant?
Patients can return to full exercise activities after one month. Light walking and lifting grocery-level heavy items after the first few days is fine. Heavy weightlifting and activities causing straining should be avoided for 4 weeks. Swimming should be avoided for 1 month. Remember that activities requiring co-ordination or depth perception will be affected until your brain adapts to the new vision in the treated eye.
Will I always need glasses after a corneal transplant?
How do I rehabilitate the vision after a corneal transplant?
Is corneal transplant surgery covered by Medicare?
How long does a corneal transplant last?
Who does my donor cornea come from?
Will I always need eye drops after a corneal transplant surgery?
Can I have cataract surgery at the same time?
What is the difference between rejection and failure?
How long will I be in hospital?
What do I do with showering after a transplant?
When can I resume full exercise after a transplant?
When can I resume wearing makeup after a transplant?
What happens during vaccinations?
When are stitches (sutures) removed after a corneal transplant?
Can the stitches (sutures) break themselves after a corneal transplant?
Patients can resume makeup wear generally after the first week or so, so long as the epithelium (skin) on the surface of the eye has healed.
Dr Trinh will advise on this after checking your eye.
Will I always need glasses after a corneal transplant?
How do I rehabilitate the vision after a corneal transplant?
Is corneal transplant surgery covered by Medicare?
How long does a corneal transplant last?
Who does my donor cornea come from?
Will I always need eye drops after a corneal transplant surgery?
Can I have cataract surgery at the same time?
What is the difference between rejection and failure?
How long will I be in hospital?
What do I do with showering after a transplant?
When can I resume full exercise after a transplant?
When can I resume wearing makeup after a transplant?
What happens during vaccinations?
When are stitches (sutures) removed after a corneal transplant?
Can the stitches (sutures) break themselves after a corneal transplant?
Patients should be aware that rejection can theoretically be more prevalent during times of vaccination because the immune system has been stimulated and is more active during this time. Signs of prolonged redness, reduced vision, sensitivity to light and pain are suspicious and you should call in to make a review appointment with Dr Trinh and her team to check.
You may choose to use your topical steroid medical four times daily for one week prior and after any planned vaccination to reduce the risks of corneal transplant rejection.
Will I always need glasses after a corneal transplant?
How do I rehabilitate the vision after a corneal transplant?
Is corneal transplant surgery covered by Medicare?
How long does a corneal transplant last?
Who does my donor cornea come from?
Will I always need eye drops after a corneal transplant surgery?
Can I have cataract surgery at the same time?
What is the difference between rejection and failure?
How long will I be in hospital?
What do I do with showering after a transplant?
When can I resume full exercise after a transplant?
When can I resume wearing makeup after a transplant?
What happens during vaccinations?
When are stitches (sutures) removed after a corneal transplant?
Can the stitches (sutures) break themselves after a corneal transplant?
Sutures for a penetrating keratoplasty (Penetrating Keratoplasty) or a deep anterior lamellar keratoplasty (Deep Anterior Lamellar Keratoplasty) are generally removed in sequential fashion from about 9 months in three month intervals.
Whilst the aim is to generally remove as many sutures are possible, if the vision becomes very functional whilst a few sutures are remaining, Dr Trinh will often pause suture removal to allow the patient to use the current shape that is providing good visual function.
Will I always need glasses after a corneal transplant?
How do I rehabilitate the vision after a corneal transplant?
Is corneal transplant surgery covered by Medicare?
How long does a corneal transplant last?
Who does my donor cornea come from?
Will I always need eye drops after a corneal transplant surgery?
Can I have cataract surgery at the same time?
What is the difference between rejection and failure?
How long will I be in hospital?
What do I do with showering after a transplant?
When can I resume full exercise after a transplant?
When can I resume wearing makeup after a transplant?
What happens during vaccinations?
When are stitches (sutures) removed after a corneal transplant?
Can the stitches (sutures) break themselves after a corneal transplant?
Sutures can break by themselves from time to time as the body does break the material down slowly. If so, the broken suture may cause a chronic foreign body sensation and is at risk of causing infection (as the bacteria infect the “tract” of the suture) or rejection (by stimulating chronic inflammation). Should you develop discomfort, it is best to check in with Dr Trinh’s team or visit your local optometrist for a quick diagnostic check as these are easy to see and remove. Do not delay if discomfort persists for more than a day and does not settle with lubricant drops.
Individual outcomes vary. Your surgeon will discuss what is realistic for your eyes and your circumstances at your consultation.
All surgery carries risk; the specific risks relevant to your condition and anatomy will be discussed in detail before you proceed.
Referrals accepted from GPs, optometrists, and ophthalmologists.
Lumière Vision, G1/21 Parraween St, Cremorne NSW 2090 | (02) 9338 8888 | admin@lumierevision.com.au
Emergency: Sydney Eye Hospital Emergency Department (02) 9382 7111.