Corneal Transplant & PKP

In New York City

PKP (Penetrating Keratoplasty) grants the ability to treat disease in the epithelial, stromal, and endothelial layers. A full-thickness graft also eliminates optical interface related visual problems that may exist with lamellar transplants with a stroma-stroma interface. The cornea is the transparent front wall of the eye. A variety of conditions can affect the clarity of the cornea. Dr. Rapoport is a specialists in treating diseases of the cornea, offer both medical and surgical treatment options for these diseases.



What Cornea diseases are treated with a Corneal Transplant?

Corneal dystrophies, including Fuchs’ corneal dystrophy and anterior basement membrane dystrophies
  • Keratoconus
  • Corneal edema (swelling)
  • Corneal scars
  • Contact lens complications
  • Corneal infection
  • Corneal degeneration
In cases where the cornea is no longer functioning properly, even with optimum medical therapy for conditions such as advanced keratoconus, corneal swelling or corneal scarring, a corneal transplant may be required for visual rehabilitation.

What is a Corneal Transplant?

In a standard corneal transplant, we remove a full thickness disc of the central cornea in the operating room using microsurgical instruments. We replace this disc with a similarly sized graft of donor tissue from an eye bank. Microscopic sutures hold the graft in position as healing occurs, typically over many months to years.

What to Expect from Corneal Transplants

This outpatient procedure takes about an hour. There is mild discomfort after the surgery, and people often return to work within a week. The slow healing process is quite slow, however; vision usually takes many months to improve. Glasses or contact lenses are almost always needed to achieve the best vision after the procedure. Frequent changes in prescription are required as the shape of the cornea changes with healing.


What Is PKP?

Penetraking keratoplasty is a full-thickness transplant procedure, in which a trephine of an appropriate diameter is used to make a full-thickness resection of the patient’s cornea, followed by placement of a full-thickness donor corneal graft. Interrupted and/or running sutures are placed in radial fashion at equal tension to minimize post-operative astigmatism. Later, the sutures are removed selectively to reduce the amount of astigmatism present. A transplant can last decades with proper care. While once the most prominent type of corneal transplant, PK has been supplanted by partial thickness techniques for endothelial dysfunction without significant stromal scarring.  PKs are performed primarily for visually significant stromal scarring, opacities with an uncertain status of the endothelium or significant posterior corneal involvement, corneal ectasia (such as keratoconus and pellucid marginal degeneration, especially if there is history of hydrops), and infectious or non-infectious corneal ulcerations or perforations. 

What to Expect from PKP?

Postoperative recovery time is relatively long, sometimes taking years to achieve best-corrected visual acuity. Frequently, there is substantial postoperative refractive error due to high regular or irregular astigmatism of the graft, and a higher chance of requiring rigid gas permeable contact lens wear to correct astigmatic error. There is a higher risk of allograft rejection compared with other keratoplasty types. Additionally, PKs carry a higher lifetime risk of wound dehiscence due to the compromised tectonic strength that comes from a full-thickness wound.


PKP with Dr. Rapoport in NYC

A full thickness transplant requires careful follow up during the year post-operatively to ensure proper healing, removal of sutures and improvement of vision. Dr. Rapoport meticulously removes sutures to improve vision by checking topographies and adjusting sutures at each visit in the year post-operatively. Relying on the most modern imaging modalities that Manhattan Eye has and Dr. Rapoport’s technical skill will ensure that you have a superb post-operative course. 

Corneal Transplant with Dr. Rapoport in NYC

At Manhattan Eye, Dr. Rapoport brings the latest advancements in imaging and surgical techniques to provide the most modern techniques to patients in need of a corneal transplant. She is an expert at DMEK, DWEK, DSAEK and PKP and has published on the post-operative care of these transplants. She brings her delicate surgical touch and warm bedside manner in guiding you through the corneal transplant process.