Corneal Transplantation (Corneal Graft; Penetrating Keratoplasty; Endothelial Keratoplasty) By Melvin I Roat, MD, FACS, Sidney Kimmel Medical College at Thomas Jefferson University Reviewed / Revised Aug 2022 | Modified Sep 2022 View Patient Education Prognosis Corneal Limbal Stem Cell Transplantation Key Points Topic Resources Corneal Transplant Corneal transplantations are done for several reasons: To reconstruct the cornea (eg, replacing a perforated cornea) To relieve intractable pain (eg, severe foreign body sensation due to recurrent ruptured bullae in bullous keratopathy) To treat a disorder unresponsive to medical management (eg, severe, uncontrolled fungal corneal ulcer) To improve the optical qualities of the cornea and thus improve vision (eg, replacing a cornea that is scarred after a corneal ulcer, is clouded because of edema as occurs in Fuchs dystrophy or after cataract surgery, is opaque because of deposits of nontransparent abnormal corneal stromal proteins as occurs in hereditary corneal stromal dystrophy, or has irregular astigmatism as occurs with keratoconus) Indications The most common indications are the following: Bullous keratopathy (pseudophakic or aphakic, Fuchs endothelial dystrophy) Keratoconus Repeat graft Keratitis or postkeratitis (caused by viral, bacterial, fungal, or Acanthamoeba infection or perforation) Corneal stromal dystrophies Procedure Tissue matching is not routinely done.