Overview
Corneal transplantation, medically known as keratoplasty, is a highly specialised surgical procedure designed to replace damaged, diseased, or scarred corneal tissue with healthy donor tissue. The cornea is the clear, dome-shaped window at the very front of the eye. When it becomes clouded by conditions such as Fuchs’ endothelial dystrophy, scarred from severe infection or trauma, or distorted by advanced keratoconus, light cannot focus correctly, resulting in significant visual impairment.
Mr Arthur Okonkwo, a dual fellowship-trained Consultant Ophthalmologist based in Leeds, possesses extensive sub-specialist expertise in all modern forms of corneal transplantation. He provides comprehensive clinical assessment and performs both full-thickness and advanced partial-thickness (lamellar) grafts. By utilising the latest microsurgical techniques, he ensures that only the specifically diseased layers of the cornea are replaced whenever clinically possible.
Mr Okonkwo carefully evaluates each patient to determine the most appropriate surgical approach. His repertoire includes Penetrating Keratoplasty (PKP) for full-thickness replacement, Deep Anterior Lamellar Keratoplasty (DALK) for replacing the front layers while preserving the patient’s own endothelium, and advanced endothelial procedures such as Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK) and Descemet’s Membrane Endothelial Keratoplasty (DMEK) for inner layer disease. Every treatment plan is meticulously tailored to provide the best possible visual rehabilitation while minimising the risk of graft rejection.
Advanced Surgical Techniques
PKP (Penetrating Keratoplasty)
A traditional full-thickness transplant used when all layers of the cornea are severely damaged or scarred.
DALK (Deep Anterior Lamellar Keratoplasty)
Replaces only the front and middle layers of the cornea, preserving the patient's own healthy inner layer (endothelium) to significantly reduce the risk of rejection.
DSAEK (Descemet's Stripping Automated Endothelial Keratoplasty)
A partial-thickness procedure that replaces only the diseased inner endothelial layer with a thin disc of donor tissue, promoting faster recovery.
DMEK (Descemet's Membrane Endothelial Keratoplasty)
The most advanced form of endothelial transplant, replacing the diseased inner layer with an ultra-thin, single layer of donor cells for exceptional visual outcomes and rapid recovery.
Conditions Treated
- Fuchs' Endothelial Dystrophy
- Advanced Keratoconus
- Corneal Scarring (from trauma or infection)
- Bullous Keratopathy
- Previous Graft Failure
- Corneal Ulcers
What to Expect
1
Initial Consultation
A detailed discussion of your symptoms and medical history.
2
Diagnostic Assessment
Comprehensive corneal tomography, optical coherence tomography (OCT), and endothelial cell counts are performed to map the exact extent of the corneal disease.
3
Treatment Planning
Based on the assessment, Mr Okonkwo will determine the most suitable surgical technique (PKP, DALK, DSAEK, or DMEK) tailored to your specific corneal anatomy.
4
The Procedure
Depending on the technique, the surgery may be performed under local or general anaesthetic.
5
Immediate Aftercare
Following the procedure, patients are monitored in the clinic.
6
Follow-Up Care
Detailed instructions for steroid eye drops are provided, and regular appointments are scheduled to monitor healing, manage sutures, and check for any signs of rejection.
Frequently Asked Questions
What is the difference between a full and partial-thickness transplant?
A full-thickness transplant (PKP) replaces all layers of the cornea and is necessary when the entire cornea is diseased or heavily scarred. Partial-thickness transplants (DALK, DSAEK, DMEK) are more advanced techniques that replace only the specific diseased layers—either the front or the back—while preserving the patient’s remaining healthy tissue. Partial grafts generally offer faster recovery times and a lower risk of rejection.
How long does it take to recover from a corneal transplant?
Recovery time depends entirely on the type of procedure performed. Advanced endothelial grafts like DMEK and DSAEK often allow for significant visual improvement within a few weeks to a few months. In contrast, full-thickness grafts (PKP) and deep anterior lamellar grafts (DALK) require a much longer healing process, and it can take up to a year or more before the final visual outcome is achieved and sutures can be safely removed.
Is there a risk of my body rejecting the donor cornea?
Yes, graft rejection is a risk with any transplant procedure because the body’s immune system may recognise the donor tissue as foreign. However, the cornea has a unique “immune privilege,” making rejection less common than with other organ transplants. The risk is also significantly lower with partial-thickness techniques like DALK and DMEK. Mr Okonkwo will prescribe steroid eye drops to suppress the immune response and closely monitor your eye for any early signs of rejection, which can usually be successfully treated if caught early.
Where does the donor corneal tissue come from?
Donor tissue is provided by national eye banks, which carefully screen all donors for infectious diseases and assess the health and quality of the corneal tissue before it is approved for surgical use. The UK has strict regulations ensuring the safety and ethical sourcing of all donor tissue.
Will I need to wear glasses after a corneal transplant?
It is highly likely that you will still need to wear glasses or contact lenses after a corneal transplant to achieve your best possible vision. The primary goal of the surgery is to restore a clear, healthy cornea rather than to completely eliminate refractive errors. Once the eye has fully healed and all necessary sutures have been removed, Mr Okonkwo will discuss the best options for final visual correction, which may include specialised contact lenses or, in some cases, subsequent laser vision correction.
Quick Info
Duration
Surgery typically takes between 1 to 2 hours, depending heavily on the specific technique (PKP, DALK, DSAEK, or DMEK) being performed.
Recovery
Recovery varies significantly by procedure. Endothelial grafts (DMEK/DSAEK) offer faster visual recovery (weeks to months), while full-thickness grafts (PKP) may take up to a year or more for vision to fully stabilise.
Specialist Care
All treatment is strictly Consultant-led by a dual fellowship-trained corneal specialist, ensuring expert surgical care and long-term management.
Ready to Get Started?
Book a consultation to discuss your symptoms and treatment options.
Ready to Discuss Your Vision?
If you have been diagnosed with a corneal condition requiring surgical intervention, expert assessment and advanced treatment are available. Book a consultation to explore your tailored corneal transplantation options.