The cornea is made of layers, and modern surgery replaces only the diseased layer instead of the whole cornea. In endothelial disease (such as Fuchs' dystrophy or corneal swelling after surgery) only the back layer is transplanted via DMEK or DSEK, through a small incision with quick recovery. In advanced keratoconus and superficial scars the front layers are replaced via DALK, keeping the patient's own endothelium and lowering rejection risk. Full-thickness PKP is reserved for cases involving all layers.
Signs & who it is for
- Corneal swelling with morning blur that clears during the day (endothelial disease)
- Corneal scars after infection or injury that block vision
- Advanced keratoconus not helped by rings or lenses
- Failure of a previous corneal graft
When is it recommended?
When vision is poor because of corneal disease that drops, lenses or simpler procedures cannot help. The type of transplant is chosen precisely according to the affected layer after imaging and microscopic examination of the cornea.
Options & techniques
- DMEK: transplanting the endothelial membrane only — fastest recovery, least rejection
- DSEK: endothelium with a thin supporting layer
- DALK: front layers transplanted, patient's own endothelium preserved
- PKP: full-thickness transplant
- Long-term follow-up with drops to prevent rejection
Frequently asked questions
Where does the donor cornea come from?
From accredited eye banks that screen tissue thoroughly before use and supply whole corneas or pre-prepared layers for transplantation.
Book your appointment in Riyadh
Dr. Sulaiman Al Habib Specialist Hospital – Riyadh · By appointment — call or WhatsApp for the next available slot