Corneal transplant

An operation to replace a cloudy, scarred or misshapen cornea, or part of it, with healthy donor tissue to improve sight, relieve pain or treat damage.

✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review

In short

A corneal transplant replaces a cloudy, scarred or misshapen cornea, or part of it, with donor tissue.
Recovery is slow — vision can take many months, and after a full-thickness graft a year or more, to settle.
Most people still need glasses or contact lenses, and the graft can carry stitches for a year or longer.
Rejection is a lifelong risk; learn the warning signs (red eye, light sensitivity, vision drop, pain) because early treatment often saves the graft.

A plain-English summary. The detail — including risks and recovery — is below.

At a glance

TypeEye operation (transplant)

AnaestheticLocal anaesthetic, sometimes with sedation, or general anaesthetic

How long it takesUsually about an hour, depending on the type

Hospital stayOften day case, sometimes an overnight stay

Time off workAbout 2–4 weeks off work; full visual recovery takes much longer

When you'll see resultsVision improves slowly, sometimes over many months to a year or more

On the NHS?Available on the NHS when clinically needed; donor tissue comes from the eye bank

A general guide. Your surgeon will give you advice for your situation.

Best fit

Can clear a cloudy or scarred cornea and improve sight

Pause if

An eye with severe surface disease or uncontrolled glaucoma may have a poor graft outlook and need that treating first.

Main recovery point

The eye is sore, watery and light-sensitive and vision is very blurry. You use frequent drops and protect the eye with a shield, especially at night.

Good aftercare

Clear, written rejection warning signs and a same-day urgent contact route.

First week

The eye is sore, watery and light-sensitive and vision is very blurry. You use frequent drops and protect the eye...

First weeks

Soreness settles and vision slowly clears a little. You avoid rubbing the eye, heavy lifting and getting water in...

First few months

Vision keeps improving and the eye is reviewed often. Stitches may be adjusted or some removed; with endothelial...

Up to a year or more

For full-thickness grafts, vision can take a year or longer to reach its best, and stitches are often removed...

Medical line illustration of corneal transplant laser eye for Corneal transplant. — Illustration only - not a diagnosis, medical advice or a promise of result. Your anatomy and treatment plan may differ. Vuemedics does not publish before-and-after photos.

What is a corneal transplant?

The cornea is the clear window at the front of the eye that lets light in and helps focus it. If it becomes cloudy, scarred or badly misshapen — for example by keratoconus, Fuchs' dystrophy, infection or injury — vision can become very blurred and the eye may be painful.

A corneal transplant replaces the damaged cornea, or just the affected layers, with healthy tissue from a donor. Modern surgery can replace the full thickness (penetrating keratoplasty), most of the front layers (deep anterior lamellar keratoplasty, DALK), or only the thin inner layer (endothelial keratoplasty, DMEK or DSAEK), depending on which part is diseased.

The most important thing to expect is that recovery is slow. Vision often improves only gradually over many months, and after full-thickness grafts it can take a year or longer to settle. Most people still need glasses or contact lenses afterwards. There is also a lifelong, though usually manageable, risk that the body tries to reject the graft.

Types & techniques

There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.

Penetrating keratoplasty (PK)

The full thickness of a central disc of cornea is removed and replaced with a matching donor disc, held in with very fine stitches. Used when all layers are affected.

Deep anterior lamellar keratoplasty (DALK)

Most of the cornea is replaced but your own healthy inner layer is kept. Because the inner layer is not transplanted, the risk of rejection is lower. Often used for keratoconus and front-layer scarring.

Endothelial keratoplasty (DSAEK/DMEK)

Only the thin inner layer is replaced, through a small incision, when conditions like Fuchs' dystrophy affect that layer. Recovery of vision is usually faster than with a full-thickness graft.

Repeat or therapeutic graft

A further transplant if a previous graft fails, or an urgent graft to treat severe infection or a perforated cornea, where the outlook depends on the underlying problem.

Common types of corneal transplant

Type	What is replaced	Recovery of vision
Penetrating (PK)	Full thickness	Slow, often a year or more
DALK	Front layers only	Slow, but lower rejection risk
DMEK/DSAEK	Thin inner layer	Usually faster than PK

Which type suits you depends on which layers of your cornea are diseased. Your surgeon will explain why one approach is chosen.

Preparing for your surgery

Ask which type of transplant is planned and why, as recovery and rejection risk differ between them.
Understand that vision recovers slowly and that you will likely still need glasses or contact lenses.
Tell the team about all your medicines and any other eye conditions such as glaucoma or dry eye.
Arrange a lift home and help at home, as the eye will be sore and vision blurry at first.
Plan for frequent follow-up visits, especially in the first year, and for using drops for a long time.
Ask how long stitches stay in and what activities you should avoid while the graft heals.

What happens

Surgery is done under local anaesthetic (sometimes with sedation) or general anaesthetic and usually takes about an hour. For a full-thickness graft, the surgeon removes a central disc of your cornea and stitches in a matching disc of donor cornea using extremely fine stitches.

For partial transplants, only the diseased layers are replaced: DALK keeps your own inner layer, while DMEK or DSAEK replaces just the thin inner layer through a small cut, often using an air or gas bubble to hold the new layer in place. You go home with a shield or pad over the eye and a course of eye drops to prevent rejection and infection.

Is this operation right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

May not be suitable if…

An eye with severe surface disease or uncontrolled glaucoma may have a poor graft outlook and need that treating first.
A partial graft is not suitable if all layers of the cornea are diseased.
An eye with no realistic vision potential may not benefit, though a graft may still relieve pain.
Someone unable to use anti-rejection drops or attend frequent follow-up faces a higher risk of failure.

Delay surgery if…

There is active infection or inflammation in the eye that should be controlled first (unless surgery is needed urgently to treat it).
Eye pressure (glaucoma) or severe dry eye is not yet under control.
Other planned eye surgery, such as cataract removal, needs sequencing with the graft.
You cannot commit to the early intensive follow-up and drop regime.

Alternatives to discuss

Glasses, specialist hard or scleral contact lenses, especially for keratoconus.
Corneal cross-linking to stiffen the cornea early in keratoconus and avoid or delay a graft.
Medical treatment of the underlying condition, for example for swelling or infection.
A partial rather than full-thickness graft where only some layers are diseased.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

What matters most to me?

Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.

What are all my options?

Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.

What would make me pause?

Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.

What happens if I do nothing today?

For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.

Anaesthetic choices

The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.

Local anaesthetic

Injections around the eye numb it while you stay awake; used for many grafts.

Local anaesthetic with sedation

Adds medicine to help you relax during surgery under local anaesthetic.

General anaesthetic

Often used for full-thickness grafts or where you prefer to be asleep or cannot lie still.

Benefits

Can clear a cloudy or scarred cornea and improve sight
Can relieve pain from a damaged or swollen cornea
Can treat severe infection or a perforated cornea
Partial transplants can lower rejection risk or speed recovery
Can restore enough vision for daily life, often with glasses or lenses

Risks & complications

More common

Slow recovery of vision over many months
Needing glasses or contact lenses afterwards, often for astigmatism
A red, gritty, light-sensitive eye while it heals
Long courses of eye drops and frequent follow-up visits

Less common

Graft rejection, where the body attacks the donor tissue
Raised pressure inside the eye (glaucoma) or cataract
A loose or broken stitch needing removal
Slow healing or surface problems on the graft

Rare but serious

Graft failure needing a repeat transplant
Serious, sight-threatening infection inside the eye
Severe bleeding during surgery or wound problems after injury

The two big themes are slow recovery and the lifelong risk of rejection. Rejection can often be reversed if treated early, which is why you must know the warning signs. Full-thickness grafts carry a higher rejection risk than partial grafts such as DALK or endothelial transplants. Ask your surgeon which type you are having, your particular rejection risk, and exactly what to do if the eye becomes red, painful, light-sensitive or your vision drops.

Published figures to discuss

Graft survival and rejection risk vary a lot with the type of transplant and the reason for it. Grafts for keratoconus do better than grafts in eyes with infection, surface disease or previous failed grafts. The figures below are from selected series and your surgeon's assessment of your eye matters most.

Figure	Reported range	How to interpret it	Source / confidence
Graft rejection episode (full-thickness, PK)	Around 1 in 6 in the first two years in one specialist source; lower with partial grafts	Often reversible if treated early, which is why warning signs must be acted on quickly.	Ten-year outcomes after DMEK, DSAEK and PK (graft survival, rejection) — PMCncbi.nlm.nih.govPublished figure
Reaching driving-standard vision after full-thickness graft	Around 75% in one specialist source	Most people still need glasses or contact lenses, often for astigmatism.	Ten-year outcomes after DMEK, DSAEK and PK (graft survival, rejection) — PMCncbi.nlm.nih.govPublished figure
Sight-threatening infection inside the eye	Rare — around 1 in 1,000 in one specialist source	Why a red, painful eye with worsening vision or discharge needs urgent care.	Ten-year outcomes after DMEK, DSAEK and PK (graft survival, rejection) — PMCncbi.nlm.nih.govPublished figure

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

Recovery — what to expect, and when

Recovery is gradual and often long. The eye is sore and the vision blurry at first, and the cornea settles slowly — after a full-thickness graft it can take a year or more before vision is at its best, and glasses or contact lenses are usually still needed.

First week

The eye is sore, watery and light-sensitive and vision is very blurry. You use frequent drops and protect the eye with a shield, especially at night.

First weeks

Soreness settles and vision slowly clears a little. You avoid rubbing the eye, heavy lifting and getting water in the eye. Most people take a few weeks off work.

First few months

Vision keeps improving and the eye is reviewed often. Stitches may be adjusted or some removed; with endothelial grafts vision usually clears faster than with full-thickness grafts.

Up to a year or more

For full-thickness grafts, vision can take a year or longer to reach its best, and stitches are often removed around or after a year. Glasses or contact lenses are usually needed.

Lifelong

Anti-rejection drops may continue for a long time, and you stay alert to the warning signs of rejection for the life of the graft.

What's normal — and not a worry

A red, watery, gritty and light-sensitive eye for the early weeks
Very blurry vision that clears only slowly over months
Awareness of stitches and the need to protect the eye
Using anti-rejection and other drops for a long time
Still needing glasses or contact lenses for best vision

Aftercare

Use all prescribed drops, especially the anti-rejection (steroid) drops, exactly as directed.
Protect the eye with a shield at night and avoid rubbing or pressing on it.
Avoid heavy lifting, contact sports, swimming and getting water in the eye until cleared.
Wear sunglasses for light sensitivity and protect the eye from injury, as a grafted eye is more vulnerable.
Attend all follow-up visits, which are frequent in the first year.
Learn the warning signs of rejection and seek help the same day if they occur.
Do not stop your drops without advice, as this can trigger rejection.

Before-surgery checklist

All prescribed drops collected, with a clear schedule
Eye shield for night-time protection
Lift home and help for the first days arranged
Time off work agreed and follow-up visits noted
Written rejection warning signs (red, sensitive, vision drop, pain)
Emergency eye contact number saved

Scars and how they heal

There is no skin scar, but there is a circular join between your cornea and the donor tissue, secured by very fine stitches that are often left in for a year or longer. Some stitch marks and a faint join can remain, and the shape of the healed cornea can cause astigmatism that needs glasses or contact lenses.

⚠ Get urgent help if…

A newly red eye, especially with light sensitivity (signs of possible rejection)
A drop or sudden change in your vision
Increasing eye pain, particularly with nausea (possible raised pressure)
Discharge, increasing redness or a white spot on the cornea (possible infection)
A loose, broken or protruding stitch, or feeling something on the surface of the eye
Any injury to the eye, which needs urgent assessment

Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your surgeon gives you.

Results & realistic expectations

A good result is a clear, comfortable graft that lets in light and improves vision, though most people still need glasses or contact lenses, often for astigmatism. Recovery is slow, and the final level of vision depends on the type of graft and the original problem.

Grafts done for conditions like keratoconus tend to do well, while grafts in eyes with severe infection, surface disease or previous failed grafts have a less certain outlook. Your surgeon should give you a realistic picture for your eye and explain that the graft needs lifelong care.

How long it lasts

Many corneal grafts last for years, and some last decades, especially in lower-risk eyes such as those with keratoconus. However, grafts can fail over time, and rejection or other problems can shorten their life, so a repeat transplant is sometimes needed. Lifelong follow-up and prompt treatment of rejection give the graft the best chance.

Combining with other procedures

A corneal transplant is sometimes combined with cataract surgery, or done in stages with it, and occasionally with surgery to control eye pressure. Endothelial grafts in particular are often planned around cataract surgery. Your surgeon will explain whether anything is best done at the same time.

Follow-up & long-term care

Follow-up is frequent, especially in the first year, to check the graft is clear, the pressure is normal and there are no signs of rejection, and to adjust or remove stitches. Tell the team the same day if you notice any warning signs of rejection or infection between visits.

Long-term anti-rejection (steroid) eye drops as advised
Frequent follow-up in the first year, then ongoing checks
Stitch removal or adjustment, often around or after a year for full-thickness grafts
Glasses or contact lenses for best vision, updated as the cornea settles
Lifelong awareness of rejection warning signs and prompt treatment
Eye protection because a grafted eye is more vulnerable to injury

Revision and secondary surgery reality

Grafts can fail over time and a repeat transplant is sometimes needed.
Repeat grafts can carry a higher rejection and failure risk than the first.
Stitches often need adjusting or removing, sometimes more than once.
Glasses, contact lenses or further procedures may be needed to deal with astigmatism.

Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.

What good aftercare looks like

Clear, written rejection warning signs and a same-day urgent contact route.
A defined schedule of frequent early follow-up and a clear drop regime.
A plan for stitch removal and for correcting astigmatism with glasses or lenses.
Lifelong monitoring of the graft and prompt treatment of any rejection.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

Type of transplant (full-thickness or partial) and its complexity
Surgeon's (corneal specialist) fee
Anaesthetic and theatre or facility fees
Donor tissue and eye-bank costs
Frequent follow-up visits, especially in the first year
Whether cataract or other surgery is combined or needed later

Make sure your written quote includes

The corneal surgeon's fee
Theatre/facility and anaesthetic fees
Donor tissue costs
How many follow-up visits in the first year are included
Cost of stitch removal and long-term drops
What happens, and what it costs, if the graft is rejected or fails and needs redoing

On the NHS? Corneal transplants are available on the NHS when clinically indicated, using donor tissue from the eye bank; private care is used mainly for choice of surgeon or timing of non-urgent surgery.

You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

Choosing a surgeon safely

Check your surgeon is on the GMC Specialist Register for this area.
Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

How Vuemedics verifies every consultant →

Questions to ask your medical professional

Take this to your consultation. A good surgeon will welcome every one of these.

Which type of transplant do I need (PK, DALK or endothelial) and why?
What is my particular risk of rejection, and how long will I need anti-rejection drops?
How long until my vision settles, and will I need glasses or contact lenses?
When will my stitches be removed?
Exactly what should I do, and who do I contact, if I get warning signs?
What is the outlook if this graft fails?
Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
Will you be the surgeon who carries out my operation, and who looks after me afterwards?
What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
What does a realistic result look like — and what can this operation not achieve?
What are my options, including waiting, doing nothing for now, or choosing a different approach?
Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Frequently asked questions

How long until my vision is good again?

Recovery is slow. After a full-thickness graft it can take a year or longer for vision to settle, while partial (endothelial) grafts often clear faster. Most people still need glasses or lenses.

What is graft rejection?

Rejection is when the body's immune system attacks the donor tissue. It can often be reversed if treated early, which is why you must know the warning signs and seek help the same day.

What are the warning signs I should watch for?

A newly red eye, sensitivity to light, a drop in vision or eye pain. If you notice any of these, contact the eye team urgently — do not wait.

Where does the donor cornea come from?

From people who have donated their corneas after death, supplied through an eye bank. Tissue is carefully checked before it is used.

Will I still need glasses or contact lenses?

Usually yes. The healed cornea often has astigmatism, so glasses or contact lenses are commonly needed for the best vision.

Can a graft fail and be redone?

Yes. Grafts can fail over time or after rejection, and a repeat transplant is sometimes done, though repeat grafts can carry a higher risk than the first.

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: Moorfields Eye Hospital — corneal transplantation (penetrating keratoplasty) Royal College of Ophthalmologists — patient information NHS Blood and Transplant — eye (cornea) donation Ten-year outcomes after DMEK, DSAEK and PK (graft survival, rejection) — PMC DALK versus penetrating keratoplasty outcomes — PMC

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.