Endothelial keratoplasty

Advanced surgery for corneal health

Endothelial Keratoplasty is a specialised type of eye surgery that targets the innermost layer of the cornea, known as the endothelium. This procedure is typically performed to treat corneal swelling or other issues affecting this crucial layer of the eye.

During Endothelial Keratoplasty, the damaged endothelial tissue is carefully removed and replaced with healthy donor tissue. This method is less invasive than traditional corneal surgery, often resulting in quicker recovery times and improved visual outcomes for patients.

If you’re experiencing problems with your corneal health, Endothelial Keratoplasty is an effective solution to consider.

Who is a Candidate?

Patients with corneal endothelial dysfunction (the innermost corneal cell layer that pumps out excess fluid) leading to corneal swelling and vision loss.

Common indications include:

• Fuchs’ endothelial dystrophy
• Pseudophakic bullous keratopathy (corneal swelling after cataract surgery)
• Irreversible endothelial damage from trauma, infection, or previous surgery.

Suitable when the rest of the cornea is healthy.

Recovery Timeline

This is likely to vary with provider.

• Hospital stay: Usually day surgery under local or general anaesthesia
• Initial recovery:
  • Vision often improves within days to weeks (faster than full-thickness grafts)
  • Some blurriness may persist for a few months.
• Return to light activities: within 1–2 weeks.
• Full visual recovery: typically 3–6 months, depending on graft clarity and healing.
  

Benefits

• Selective replacement of only the diseased endothelial layer — less invasive than full corneal transplant
• Faster visual recovery and lower risk of rejection
• Stronger corneal structure (no full-thickness incision → less astigmatism)
• Smaller incision → fewer sutures and faster healing.

Risks

• Graft dislocation (most common early issue; may need repositioning)
• Graft failure or rejection
• Infection, increased intraocular pressure (IOP), or interface haze
• Endothelial cell loss over time (affecting long-term graft survival)
• Rare risk of secondary glaucoma or cataract formation.

This is just an outline. Your specialist eye surgeon will be able to talk to you about these issues in more detail and make sure that there is informed consent.

Endothelial keratoplasty has revolutionised corneal transplantation, offering faster recovery, better vision and fewer complications than traditional full-thickness grafts.