Penetrating Keratoplasty (PKP)
Ophthalmology: Full-Thickness Corneal Transplantation
1. Procedure Overview
Penetrating Keratoplasty (PKP) is a full-thickness corneal transplant where a trephine is used to remove a diseased central corneal button, which is replaced by a healthy donor corneal graft and secured with microsutures.
2. Indications & Clinical Considerations
| Indication | Clinical Context |
|---|---|
| Keratoconus | Advanced cases with corneal scarring or intolerance to contact lenses. |
| Bullous Keratopathy | Decompensated cornea following cataract surgery (pseudophakic bullous keratopathy). |
| Corneal Scars | Post-traumatic or post-infectious corneal opacification causing visual impairment. |
3. Forensic & Clinical High-Yield Pearls
- Rejection: The most significant postoperative concern. Watch for the Khodadoust line (an endothelial rejection line). Patients must be educated on classic signs: redness, pain, decreased vision, and photophobia.
- Steroid Management: Long-term topical steroids are required to prevent immune-mediated graft rejection.
- Astigmatism: High postoperative astigmatism is common due to suture tension, often requiring selective suture removal.
- Educational Resource: For more detailed surgical techniques, rejection management protocols, and practice questions, visit mymedschool.org.