Full-Thickness Corneal Transplant (PKP)
Penetrating keratoplasty for deep scarring, advanced keratoconus, and failed grafts — when replacing the entire cornea is the right answer.
Penetrating keratoplasty (PKP) replaces the full thickness of the central cornea with donor tissue, secured with very fine sutures. It is used when corneal damage extends through all layers — deep scarring, advanced keratoconus, perforation, or a failed previous graft. Recovery is measured in months to over a year, and astigmatism afterward is common and manageable. Where only the inner layer is diseased, Dr. Feiz uses DMEK or DSEK instead, which recover far faster. PKP is performed at Aspen Surgery Center and is covered by Medicare and medical insurance.
When PKP is the right operation
- Deep central corneal scarring from infection, herpes, or trauma
- Advanced keratoconus where the cornea is too steep, thin, or scarred for specialty contact lenses
- Corneal perforation or impending perforation
- Failed previous graft
- Corneal degenerations and dystrophies affecting the full thickness
The decision to proceed is rarely urgent, and it is worth making slowly. Dr. Feiz will be explicit about what a transplant can and cannot deliver for your particular eye — and where a scleral lens or another approach would serve you better without surgery.
What to expect
- Surgery — outpatient at Aspen Surgery Center under local anesthesia with sedation. A circular section of your cornea is removed and replaced with matched donor tissue, secured with sutures finer than a human hair.
- First weeks — vision is blurry and the eye is sensitive. Frequent steroid and antibiotic drops; a shield at night.
- Months 2–12 — vision improves gradually. Sutures are selectively removed or adjusted over time to reduce astigmatism.
- Final refraction — once the eye is stable, usually after 12–18 months, a glasses or contact lens prescription is finalized. Some patients benefit from a laser touch-up at that stage.
Living with a graft
A corneal transplant is a long-term relationship, not a one-time event. Low-dose steroid drops usually continue indefinitely, annual follow-up matters, and any sudden redness, pain, light sensitivity, or drop in vision should be reported the same day — early treatment reverses most rejection episodes. With that care, grafts commonly remain clear for decades.
Ask about corneal transplantationCall 925-705-7299
Frequently asked questions
When is a full-thickness transplant necessary?
When the damage involves the full depth of the cornea: deep central scarring from infection or injury, advanced keratoconus that specialty lenses can no longer correct, corneal perforation, or a previous graft that has failed. If only the inner layer is diseased, DMEK or DSEK is the better operation.
How long is recovery?
Longer than any other eye surgery. Useful vision returns over months, and the final prescription is not stable until the sutures have been adjusted and removed, which can take a year to eighteen months. Patience is genuinely required.
Will I need glasses or contacts afterward?
Usually. A full-thickness graft often leaves astigmatism, which is managed with glasses, rigid gas-permeable or scleral lenses, or occasionally a laser touch-up once everything has stabilized.
What about rejection?
Rejection risk is higher than with partial-thickness transplants and remains for the life of the graft, which is why long-term steroid drops and follow-up are essential. Most rejection episodes can be reversed if treated promptly — sudden redness, light sensitivity, pain, or a drop in vision should be reported the same day.
Where does the donor tissue come from?
From an eye bank, which screens and evaluates all tissue against national standards before it is released for transplantation.