When people search for “what is corneal transplant surgery”, it usually means they have been told that their cornea is damaged, scarred, or too weak to give clear vision anymore. The next step is understanding exactly what this surgery involves, why it might be needed, and what results they can realistically expect.
In Dubai, many patients with advanced corneal disease, keratoconus, or severe scarring look for a specialist who not only understands the science but also has day-to-day experience with complex corneal operations. At Sharif Eye Centers in Dubai Healthcare City, Dr. Tarek Abdelsamie the best eye doctor in Dubai performs both full and partial corneal transplants, alongside other advanced procedures such as intracorneal ring implantation for keratoconus, cataract surgery with premium lenses, and laser vision correction.
This explanation focuses on one clear question: what is corneal transplant surgery, step by step, in language patients and their families can easily understand.
What Is Corneal Transplant Surgery?
Corneal transplant surgery (also called keratoplasty) is an eye operation that replaces a damaged or diseased cornea with healthy donor corneal tissue. The aim is to restore clarity to the “front window” of the eye so that light can pass through properly and vision can improve.
The cornea is the transparent, dome-shaped layer at the front of the eye. It is responsible for:
- Protecting the inner eye
- Focusing incoming light onto the retina
- Playing a major role in the sharpness and quality of vision
When the cornea becomes cloudy, scarred, misshapen, or swollen, glasses and contact lenses often cannot solve the problem. In these situations, replacing all or part of the cornea with donor tissue can be the best way to restore clearer sight.
When Is Corneal Transplant Surgery Needed?
Understanding what corneal transplant surgery is also means understanding why it is done. Common reasons include:
- Advanced keratoconus
The cornea becomes thin and cone-shaped, causing distorted vision. In early stages, glasses, contact lenses, or intracorneal ring segments may help. In advanced stages with scarring or very irregular shape, transplantation may be required. - Dense corneal scars
These may follow infections, injuries, chemical burns, or previous surgeries and can block or distort light entering the eye. - Inherited corneal diseases (corneal dystrophies)
For example, endothelial problems that cause swelling and clouding of the cornea. - Severe corneal swelling (decompensation)
Often due to a weak endothelial cell layer, which can happen spontaneously or after previous eye surgery. - Permanent damage after severe infection or ulcer
When the cornea heals with dense scars that significantly reduce vision or cause chronic pain.
In each of these situations, the key idea is the same: the cornea is no longer clear or regular enough to allow good vision, and replacing the damaged tissue with healthy tissue becomes the most effective option.
Types of Corneal Transplant Surgery
An important part of answering what is corneal transplant surgery is recognising that there is more than one type. Modern ophthalmology has moved far beyond the “one standard transplant for everyone”. Instead, there are several approaches, depending on which layers of the cornea are diseased.
1. Full-Thickness Corneal Transplant (Penetrating Keratoplasty – PK)
In penetrating keratoplasty (PK), the surgeon removes a circular piece containing all layers of the patient’s cornea and replaces it with a matching circular piece from a donor cornea. The new tissue is sutured (stitched) in place with fine, microscopic stitches.
PK is usually chosen when the entire thickness of the cornea is affected, for example by deep scarring, advanced keratoconus with scarring, or severe damage from injury or infection.
2. Partial-Thickness Corneal Transplants (Lamellar Keratoplasty)
Over recent years, many patients have benefited from partial-thickness transplants, where only the diseased layer is replaced and healthy layers are preserved. This can mean faster healing and less risk of rejection.
The main types include:
Deep Anterior Lamellar Keratoplasty (DALK)
- Used when the front layers of the cornea (stroma) are diseased, but the inner endothelial layer is still healthy.
- Very common in keratoconus and some superficial scars.
- The surgeon removes the front layers of the cornea and replaces them with donor tissue while preserving the patient’s own endothelium.
- Preserving the natural endothelium often lowers the risk of rejection and can improve long-term stability.
Endothelial Keratoplasty (DSEK / DSAEK / DMEK)
These procedures replace only the inner (endothelial) layer of the cornea, which is responsible for pumping out fluid and keeping the cornea clear.
They include:
- DSEK / DSAEK (Descemet’s Stripping (Automated) Endothelial Keratoplasty)
A thin layer of donor tissue including endothelium and part of the stroma is inserted and attached to the back of the cornea. - DMEK (Descemet Membrane Endothelial Keratoplasty)
An even thinner graft, made only of Descemet’s membrane and endothelium, is transplanted. DMEK often provides very sharp visual results and has low rejection rates in suitable candidates.
These techniques are particularly helpful when corneal swelling is due to endothelial failure (for example in certain dystrophies or after complicated cataract surgery) but the front layers of the cornea are relatively clear.
How Does Corneal Transplant Surgery Work?
To understand what corneal transplant surgery is in practical terms, it helps to imagine the patient’s journey in stages.
1. Pre-Operative Assessment
Before surgery, the eye is thoroughly evaluated. This usually includes:
- Vision testing and refraction
- Corneal topography (mapping) and thickness measurements
- Detailed slit-lamp examination
- Retinal and optic nerve assessment when needed
At Sharif Eye Centers in Dubai Healthcare City, Dr. Tarek Abdelsamie also evaluates:
- The exact layer and pattern of damage in the cornea
- Whether a full or partial transplant is more appropriate
- Whether additional procedures, such as cataract surgery or intracorneal ring segments, should be combined or staged
This planning step is crucial to choosing the best surgical strategy for long-term vision and stability.
2. The Day of Surgery
Corneal transplant surgery is generally performed under local anaesthesia with sedation or, in some cases, general anaesthesia. The eye is cleaned and prepared in a sterile environment.
Depending on the chosen technique:
- A precise circular trephine (a specialised cutting instrument) is used to remove the diseased corneal tissue.
- Donor corneal tissue, prepared to match the required size and thickness, is positioned in place.
- In full-thickness surgery, fine sutures secure the graft 360 degrees.
- In lamellar/endothelial surgery, the graft may be held in place with smaller incisions and, in endothelial procedures, with an air or gas bubble inside the eye to help it adhere.
The surgery is performed using an operating microscope and delicate instruments, demanding high precision and experience.
3. Immediately After Surgery
- The eye is usually patched or shielded for protection.
- Patients receive instructions on medications (antibiotic and anti-inflammatory drops) and how to protect the eye, especially while sleeping.
- Vision is typically blurry at first and gradually improves over weeks to months, depending on the type of transplant and individual healing.
Recovery After Corneal Transplant Surgery
Recovery is an essential part of understanding what corneal transplant surgery is. It is not a quick, overnight change; it is a process.
- Vision improvement often starts within the first weeks but can continue to refine over several months.
- Partial transplants (like DALK or DMEK/DSAEK) often have faster visual recovery compared with traditional full-thickness transplants, because less tissue is replaced and fewer stitches are used.
- Sutures in full-thickness grafts may stay in place for many months and are removed step by step, depending on healing and astigmatism.
Consistent follow-up visits are critical. At each visit, Dr. Tarek Abdelsamie checks:
- Corneal clarity
- Graft position and stability
- Eye pressure
- Signs of inflammation or early rejection
Eye drops are adjusted over time, and additional measures (such as glasses, contact lenses, or minor laser procedures) may be recommended to refine the final visual result when healing is stable.
What Are the Risks of Corneal Transplant Surgery?
Like any intraocular operation, corneal transplant surgery carries risks. A realistic answer to what corneal transplant surgery is must include these, because informed patients make better decisions.
Possible risks include:
- Graft rejection
The immune system may recognise the donor tissue as foreign and attempt to attack it. This can usually be treated if caught early, using intensified eye drops and, in some cases, systemic medication. - Infection
Any surgical wound can become infected, though antibiotic eye drops and sterile technique greatly reduce this risk. - Raised eye pressure (glaucoma)
Sometimes related to steroid drops or surgical factors, it must be monitored and treated as needed. - Astigmatism or irregular corneal shape
Especially after full-thickness transplants where sutures can influence corneal curvature. Corrective glasses, contact lenses, or further procedures may be needed. - Graft failure
In rare cases, the transplanted tissue may not clear properly or may fail over time, requiring another graft.
Careful surgical planning, meticulous technique, and close follow-up help reduce these risks and manage them promptly if they occur.
What Results Can Patients Expect?
The goal of corneal transplant surgery is better, clearer vision and improved quality of life. In many cases, patients who previously could barely see shapes and light progress to reading, driving, using computers, and returning to everyday activities.
However, expectations must be tailored to each individual:
- Some patients may still need glasses or contact lenses for the sharpest vision, especially if there is residual astigmatism or other eye conditions.
- Coexisting problems (such as advanced retinal disease or severe dry eye) can limit the maximum achievable vision, even if the graft itself is clear.
- Long-term care is important; corneal grafts require ongoing respect and protection for many years.
At Sharif Eye Centers in Dubai Healthcare City, time is spent explaining likely outcomes in simple, honest terms so that patients know what corneal transplant surgery can and cannot do for their specific case.
Why Choose a Specialist Corneal Surgeon in Dubai?
Because corneal transplantation is technically demanding and highly individualised, many patients in Dubai prefer to be treated by a surgeon whose daily work includes:
- Full-thickness and partial-thickness corneal transplants
- Keratoconus management, including intracorneal ring segments and, when needed, corneal grafting
- Cataract surgery with premium lenses, which may be combined or sequenced with corneal procedures
- Laser vision correction, giving a comprehensive view of all options for improving sight
This is the practice focus of Dr. Tarek Abdelsamie at Sharif Eye Centers in Dubai Healthcare City. His experience in both corneal and lens-based surgery means that corneal transplant decisions are made in the context of the whole visual system, not in isolation. That perspective helps patients avoid unnecessary surgery, choose the right type of transplant when needed, and integrate their corneal treatment with any future procedures they might require.
Bringing It All Together
In simple terms, what is corneal transplant surgery?
- It is a procedure that replaces a damaged or diseased cornea with healthy donor tissue so that light can enter the eye clearly again.
- It can be performed as a full-thickness replacement or a partial-thickness graft, depending on which layers are affected.
- It requires careful pre-operative assessment, precise surgery, and dedicated follow-up over months.
- It offers many patients a chance to regain clarity, comfort, and independence in their daily lives.
For people in Dubai who have been told they may need a corneal transplant, consulting a dedicated corneal specialist like Dr. Tarek Abdelsamie at Sharif Eye Centers in Dubai Healthcare City can turn a frightening idea into a structured, understandable plan. With the right guidance, corneal transplant surgery becomes not just a technical term, but a real opportunity to see the world more clearly again.
