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In more severe cases, lamellar or penetrating keratoplasty may be considered.
Primarily, large size penetrating keratoplasty has been advocated.
With penetrating keratoplasty (corneal transplant), the long term results are good-excellent.
Surgery in the form of corneal transplantation (penetrating keratoplasty) is usually necessary to save the eye.
Penetrating keratoplasty is commonly performed for extensive corneal dystrophy.
Keratoconus is the most common grounds for conducting a penetrating keratoplasty, generally accounting for around a quarter of such procedures.
Historically, penetrating keratoplasty, or full thickness corneal transplantation, was the treatment of choice for irreversible endothelial failure.
Transplantation of the entire thickness of the cornea (penetrating keratoplasty) may be performed if there is enough normal tissue present.
Penetrating keratoplasty (PK)
Penetrating keratoplasty is preferred when the disease process involves irreversible damage not just to the corneal endothelium, but to other layers of the cornea as well.
In common with penetrating keratoplasty, the requirement for some vision correction in the form of spectacles or hydrophilic contact lenses may remain subsequent to the operation.
Superficial corneal dystrophies do not need a penetrating keratoplasty as the deeper corneal tissue is unaffected, therefore a lamellar keratoplasty may be used instead.
Definitive treatment, however, (especially with increased corneal edema) is surgical in the form of corneal transplantation, or penetrating keratoplasty (PKP).
The Boston KPro is a treatment option for corneal disorders not amenable to standard penetrating keratoplasty (corneal transplantation) or corneal transplant.
The procedure requires a greater level of skill on the part of the surgeon, and is less frequently performed than a penetrating keratoplasty, as the outcome is generally less favorable.
Examples of surgical procedures used for PMD include: wedge resection, lamellar crescentic resection, penetrating keratoplasty, lamellar keratoplasty, epikeratoplasty and intracorneal segments.
The National Keratoconus Foundation reports that penetrating keratoplasty has the most successful outcome of all transplant procedures, and when performed for keratoconus in an otherwise healthy eye, its success rate can be 95% or greater.
During implantation of the device, the device is assembled with a donor corneal graft positioned between the front and back plate which is then sutured into place in a similar fashion to penetrating keratoplasty (corneal transplantation).