There is still a place for Penetrating Keratoplasty (PK)

Abstract

SummaryWith new emerging lamellar keratoplasty techniques, the number of penetrating keratoplasty has reduced, yet it is still the most commonly performed technique for corneal grafting.For many indications penetrating keratoplasty (PKP) is the best option such as keratoconus with previous hydrops and central scarring, therapeutic corneal graft and long standing bullous keratopathy with stromal scarring. Other situations such as presence of peripheral anterior synaechia, aphakia, shallow phakic eyes, DSEK and DMEK have greater risk and more loss of tissue through wastage.Advantages over other lamellar techniques are shorter learning curve, comparable or better visual outcome and in some centers better survival rate when performed for the same indication as lamellar grafts. Post‐operative astigmatism and weak graft host junction remain to be major disadvantages of this technique.Newer evolving cutting techniques of donor and recipient corneas using the femtosecond laser are being developed to address these issues, however, to date results do not justify the increase in cost.