Endothelial Keratoplasty

Only the back layer of the cornea is affected (like in Fuchs corneal endothelial dystrophy) and hence only the very back layer is removed and transplanted. EK is a revolutionary new procedure for diseases affecting the endothelial innermost layer of the cornea. It is the best and only procedure advisable in patients with disease limited to of the back of the cornea (such as Fuchs endothelial dystrophy, pseudophakic bollous keratopathy). Itentails the removal of the diseased back layer (the endothelium) only leaving intact the outer layers of the cornea.

The greatest advantages are:

  1. the surgery is performed through keyhole corneal incisions similar to those used in cataract surgery, the visual recovery is faster, the risk of rejection is less and preserves the structural integrity of the eye.
  2. The operation is also faster and is always done under local anaesthesia.

Through a small incision the patients’ endothelium is removed and a 8.5mm disc of donor endothelium is inserted and pressed in position against the back of the patient’s cornea by a bubble of air. Posturing for a few hours lying flat is needed to help the adhesion of the donor material and usually no stitches are required. A review is needed the day after the surgery and at week 1, and 3-12 months. We generally recommend that you take 1 week off work.  Patients will need to use anti-rejection steroids eye drops for 1-2 years.

Posterior Lamellar Keratoplasty, only the inner layer of the cornea are transplanted because diseased (for instance in Fuchs corneal endothelial dystrophy).

Endothelial Keratoplasty (EK)