The first step in penetrating keratoplasty is the preparation of donor tissue. The corneal button should be cut 0.25-0.50mm larger than the diameter of the host corneal opening, as it will help to reduce the excessive postoperative corneal flattening, decrease the risk of secondary glaucoma & enhances the wound closure.
The host cornea is trephined, the anterior chamber is been filled with the viscoelastic & the donor tissue is positioned endothellial side down on the recipient's eye. The cornea is then sutured in a place with either the continuous or interrupted sutures. Interrupted sutures are been chosen in thinned, vascularized or inflammed corneas also in the pediatric cases.
Penetrating keratoplasty can be combined with the intraocular lens implantation, cataract surgery, secondary, glaucoma surgery & retinal surgery.
PK has the ability to treat disease in the epithelial, stromal & endothelial layers. A full-thickness graft also eliminates the optical interface which is related to visual problems that exist with the lamellar transplants with stroma-stroma interface.
Even though, the postoperative recovery time is comparatively long, sometimes it may take some years to achieve best-corrected visual acuity.
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