Penetrating Keratoplasty (PKP): Corneal Transplant in Moscow
The cornea should be clear and smooth. Scarring, clouding, or significant thinning can blur vision, making glasses less effective.
At K+31, we perform diagnostics, evaluate the entire eye, and only then decide whether a corneal transplant is necessary.
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What is penetrating keratoplasty and when is it needed??
Penetrating keratoplasty is a microsurgical replacement of the damaged cornea with a full-thickness donor graft. This method is chosen for deep damage, when the cornea's own tissue no longer transmits light properly.
How does SKP differ from other corneal surgeries?
With layer-by-layer surgery, the surgeon replaces only the damaged layers. With SKP, the entire thickness of the corneal area is removed. Corneal surgery requires precise calculations and long-term monitoring.
Before choosing a method, it is important for the patient to understand the differences between treatment options.
| Method | When used | Advantages | Limitations |
|---|---|---|---|
| Penetrating keratoplasty | Deep scars, dense opacities | Complete tissue replacement | Longer healing time, risk of immune reaction |
| Lamellar keratoplasty | Individual layers are affected | Healthy tissue is preserved. | Not suitable for everyone. |
| Conservative treatment | Initial changes | Not surgical | Does not remove deep defects. |
The doctor makes the final decision after an in-person diagnosis.
When do we recommend a corneal transplant?
A corneal transplant is considered when scarring, deformation, or dense opacities prevent adequate vision with other methods. Common causes include:
- Trauma
- Burn
- Infection
- Inflammation
- Late-stage keratoconus
Indications for penetrating keratoplasty
Indications are assessed in person. The doctor compares complaints, visual acuity, biomicroscopy, corneal topography, pachymetry, corneal OCT, and pressure. SCC is most often discussed in the following conditions:
- Severe corneal thinning
- Deep scars from trauma, burns, or inflammation
- Persistent opacities in the optical zone
- Dystrophic changes with loss of transparency
- Failure of other treatments
Keratoconus and severe corneal thinning
Keratoconus changes the shape of the cornea: the tissue thins, bulges, and produces abnormal optics. If scarring or a risk of perforation exists, the doctor may recommend keratoplasty.
Scars, Opacities, and Trauma-Related Consequences
A corneal scar may remain after an ulcer, injury, burn, or severe keratitis. A deep central corneal scar interferes with light transmission and often requires surgical tissue replacement.
Corneal opacities are assessed by their density, depth, and location. In the case of central corneal opacity, a donor cornea helps restore the clear zone.
Inflammatory and Dystrophic Changes of the Cornea
Corneal inflammation is initially treated conservatively: an active process increases the risk of complications. Surgical intervention is discussed after stabilization if persistent corneal opacities remain. If full-thickness lesions are present, a full corneal transplant may be necessary.
General information
Post-surgery Recovery
Healing is gradual. The graft must take root, the sutures must maintain their shape, and the inflammatory reaction must remain under control. Vision recovery after SKP is assessed dynamically.
First Days after SKP: Regime and Restrictions
During the first few days, discomfort, tearing, light sensitivity, and a foreign body sensation are possible. Avoid rubbing the eye, lifting heavy objects, exposing it to water, dust, or cosmetics, and discontinue eye drops. Weight-bearing activities are resumed after the doctor's approval.
Sutures, Follow-up Examinations, and Healing Time
Corneal sutures may remain in place for a long time. They are removed based on the condition of the eye, the shape of the cornea, and the examination findings. Postoperative monitoring is necessary to monitor graft transparency, pressure, epithelial healing, and signs of inflammation.
When can vision improvement be expected?
Improvement usually develops gradually. Postoperative vision is affected by:
- Graft transparency
- Astigmatism
- Crystal lens
- Retina
- Optic nerve
Vision recovery may take months because the optic nerve does not stabilize immediately.
Frequently asked questions about penetrating keratoplasty
What is this surgery and how is it different from lamellar keratoplasty?
How long does recovery take after a corneal transplant?
Can good vision be restored after PKP?
How can I reduce the risk of complications after surgery?
Make an appointment with an ophthalmic surgeon
A consultation with an ophthalmologist at K+31 helps you determine whether keratoplasty is necessary or whether another treatment option is available. We conduct an examination and explain the results, prognosis, and limitations. If a corneal transplant is indicated, the doctor develops a plan for preparation, surgery, and follow-up.
You can schedule an appointment at a convenient time in Moscow. During your appointment, we will assess your eye condition and determine a safe treatment plan.
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How does the operation proceed?
Preparation begins before the surgery. We need to understand what kind of transplant is needed, whether there is inflammation, and whether visual potential is preserved.
"We start with diagnostics: it is important to assess the extent of corneal damage and the overall condition of the eye. This allows the doctor to choose a safe approach and explain the recovery process to the patient in advance," says an ophthalmic surgeon at K+31.
Preoperative Diagnostics and Preparation
Corneal diagnostics includes biomicroscopy, corneal topography, pachymetry, corneal OCT, and an ocular surface assessment. An ultrasound, retinal examination, and tonometry are performed as indicated. If active inflammation is present, the surgery is postponed until it stabilizes.
Stages of Penetrating Keratoplasty
The surgeon removes the affected area of the cornea of a specified diameter. A donor cornea, prepared for transplant, is inserted in its place. The transplant is secured with fine sutures.
Microsurgery of the eye requires high precision. Even minor irregularities can affect refraction, healing, and vision after surgery.
Anesthesia, duration, and postoperative monitoring
Anesthesia is selected individually. The extent of the procedure, age, comorbidities, and anxiety level are taken into account. After surgery, the patient remains under observation and receives a prescription for eye drops and follow-up appointments.