Corneal Transplant Surgery

Corneal Transplant Surgery

Partial and Full Corneal Transplants, Artificial Cornea Implants

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Corneal transplant surgery -- also called keratoplasty -- preserves or restores vision impaired by advanced corneal disease or when the cornea has been damaged by scarring, trauma, or infection. Duke corneal surgeons have extensive experience and perform hundreds of corneal transplants each year using the latest advances. Our goal is to recover or preserve your vision and help you return to your daily activities.

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When Is Corneal Transplant Surgery Necessary?

You may be a candidate for corneal transplantation if you have been diagnosed with keratoconus, which causes your cornea to become thin and cone-shaped, or when an inherited corneal dystrophy, such as Fuchs’ dystrophy, results in vision-impairing corneal swelling and clouding. You may also be a candidate for corneal transplantation if your cornea has been damaged by infection, scarring, or trauma.

The procedure is typically recommended when less-invasive corneal disease treatments, such as special glasses or contact lenses, and medications to reduce swelling cannot halt the progression of your corneal disease.

There are several types of corneal transplant procedures to remove damaged, unhealthy cornea tissue. Which procedure is right for you is determined after a comprehensive evaluation that includes sophisticated imaging of your cornea. This allows us to recommend the most effective procedure for your condition. 

Our Locations
Duke Health offers locations throughout the Triangle. Find one near you.

Surgical Techniques

Full-Thickness Corneal Transplant

During this procedure -- also called penetrating keratoplasty (PK) -- the corneal transplant surgeon removes all layers of the diseased cornea and replaces it with clear, healthy cornea tissue from a donor. It may take up to one year for your vision to reach its maximum potential.

Artificial Cornea Placement

Restores vision by removing the severely damaged or diseased cornea and replacing it with an acrylic artificial cornea and donor corneal tissue that is sutured in place.

Partial-Thickness Corneal Transplant (DSEK, DMEK, DALK)

The surgeon replaces only certain layers of your cornea with donor tissue in these alternatives to full-thickness corneal transplant. The type of procedure you receive depends on which parts of your cornea are diseased. Procedures include Descemet’s stripping endothelial keratoplasty (DSEK), Descemet’s membrane endothelial keratoplasty (DMEK), and deep anterior lamellar keratoplasty (DALK).

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Tests

Your corneal surgeon will conduct a thorough examination of your eye and its structures using a variety of imaging devices to help diagnose any corneal disorders or diseases.

Corneal Topography and Tomography

A computer-guided device creates a 3-D image map of your cornea to measure corneal power, curvature, and thickness.

Corneal Pachymetry

Ultrasound waves measure the thickness of your cornea.

Optical Coherence Tomography

OCT is a non-contact imaging test that uses light waves to take high-resolution cross-sectional pictures of your cornea. These images can be used to examine changes to the normal layered anatomy of the cornea.

Slit Lamp Exam

Gives your doctor a magnified, 3-D view of the structures at the front of your eye.

Keratometry

Measures the curvature of your cornea’s front surface to assess astigmatism.

In-Vivo Confocal Microscopy

Allows your doctor to examine the cellular structure of your cornea and to see normal and abnormal cells in the various corneal layers (epithelium, Bowman’s layer, stroma, Descemet’s membrane, and endothelium) as well as infectious cells such as fungi and amoeba.

Best Eye Hospital in NC
When it comes to your care, you want the very best. Duke University Hospital is ranked sixth in the nation and the best in North Carolina for ophthalmology.

Choosing a Corneal Transplant Surgeon

Advanced Training in Corneal Disease Management
Our corneal surgeons are ophthalmologists who have undergone advanced training in the medical and surgical management of corneal disease.

Latest Corneal Transplant Techniques
We use the latest techniques to remove only the diseased portion of the cornea, rather than all the layers of the cornea, when appropriate. These new corneal transplant procedures retain the structural integrity of your eye, minimize your risk of rejection, quicken your recovery, and improve your vision.

Artificial Cornea Implants
We are one of the few eye centers in the region with the surgical skill and expertise to treat advanced corneal disease with artificial cornea implants (keratoprosthesis). This may be an option if you have not had success with standard corneal transplants.

Innovative Assessment Using Optical Coherence Tomography (OCT)
Our researchers are studying new ways to use optical coherence tomography (OCT), a noninvasive imaging technology that allows us to look closely at the cornea and assess the severity of your corneal disease. This helps us make the best treatment recommendations for your condition.

Patient Support Services
We offer patient support services, including educational materials and programs, a low vision rehabilitation program, and a dedicated social worker to help you and your loved ones manage your condition and maximize your quality of life.