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What Is Penetrating Keratoplasty (PK)?

Penetrating keratoplasty is a full thickness corneal transplant that replaces a diseased cornea with donor tissue. Surgeons remove a circular button and secure the graft with fine sutures. PK restores clarity when scars, keratoconus, or edema have advanced. It remains a proven option when lamellar techniques are unsuitable.

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What Is Penetrating Keratoplasty (PK)?

Penetrating keratoplasty is a full thickness corneal transplant that replaces a diseased cornea with donor tissue. Surgeons remove a circular button and secure the graft with fine sutures. PK restores clarity when scars, keratoconus, or edema have advanced. It remains a proven option when lamellar techniques are unsuitable.

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How Does PK Surgery Proceed?

After trephination of host and donor, the new corneal button is sutured in place with interrupted or running stitches. Meticulous wound alignment preserves shape and reduces astigmatism. Postoperative care includes steroids, antibiotics, and pressure control. Suture adjustments fine tune vision as healing progresses.

Steps in a Full-Thickness Corneal Transplant

The procedure replaces damaged tissue with a clear donor graft. Careful stitching keeps the cornea stable while healing begins. Regular checkups guide suture removal and visual improvement. Progress often continues steadily over months.

Who Needs Penetrating Keratoplasty?

Patients with deep scars, failed previous grafts, or endothelial failure unsuitable for DMEK or DSAEK may benefit. Severe ectasia with thinning is another indication. Preoperative imaging and topography guide the choice between PK and lamellar options. Risk discussion covers rejection and refractive change.

What Are the Risks of PK?

Graft rejection, infection, glaucoma, and high astigmatism are the major concerns. Long term steroid use can raise pressure or cataract risk. Prompt attention to redness, pain, or vision drop protects the graft. Regular follow up is essential.

How Long Is Recovery After PK?

Vision improves over months as sutures settle and the eye stabilizes. Glasses or contact lenses are common for residual astigmatism. Graft survival depends on diagnosis and care adherence. Many patients achieve useful clarity and comfort.

FAQs: Penetrating Keratoplasty (PK)

Is PK still common? Yes, when disease involves full thickness or other grafts are not suitable.

How long do sutures stay? They often remain for many months before selective removal.

Can PK be repeated? Yes, but risk rises with each graft.

References

Penetrating Keratoplasty. StatPearls (NCBI Bookshelf). https://www.ncbi.nlm.nih.gov/books/NBK592388/. June 11, 2023.

Penetrating Keratoplasty. EyeWiki (American Academy of Ophthalmology). https://eyewiki.org/Penetrating_Keratoplasty. June 29, 2025.

Corneal transplantation (penetrating keratoplasty). Royal Free London NHS Foundation Trust (PDF). https://www.royalfree.nhs.uk/patients-and-visitors/patient-information-leaflets/corneal-transplantation-penetrating-keratoplasty. July 16, 2024.

Trends in keratoplasty: clinical insights and therapeutic strategies. (PMC). https://pmc.ncbi.nlm.nih.gov/articles/PMC11571050/. 2024.

Penetrating Keratoplasty for Keratoconus: A Ten-Year Follow-up. (PubMed). https://pubmed.ncbi.nlm.nih.gov/32660005/. 2020.