Corneal Transplant (Keratoplasty)
What is Corneal Transplant ?
A corneal transplant, or keratoplasty, is a surgical procedure to replace a damaged or diseased cornea with a healthy donor cornea to restore vision or relieve pain. The cornea is the clear, dome-shaped front surface of the eye that helps focus light. In India, keratoplasty is performed in ophthalmology departments at hospitals like Apollo, Fortis, Medanta, and AIIMS, often at affordable costs. Understanding the procedure, costs, recovery, risks, and frequently asked questions (FAQs) is essential for patients in India to make informed decisions.
Why do you need Corneal Transplant ?
Keratoplasty is indicated for:
- Corneal scarring or opacity:
- Keratoconus: Thinning and bulging of the cornea causing distorted vision.
- Infections: Scarring from herpes keratitis, fungal, or bacterial keratitis.
- Trauma: Injury causing corneal opacity.
- Corneal dystrophies:
- Fuchs’ dystrophy: Endothelial cell loss leading to corneal swelling (edema) and vision loss.
- Lattice or granular dystrophies: Inherited conditions causing corneal clouding.
- Corneal edema:
- Bullous keratopathy: Swelling after cataract surgery or endothelial damage.
- Corneal ulcers:
- Severe, non-healing ulcers threatening perforation.
- Failed previous transplant:
- Graft rejection or failure requiring a repeat transplant.
The procedure aims to replace the damaged cornea (fully or partially) with a donor cornea, improving vision or alleviating pain (e.g., from edema). Types include penetrating keratoplasty (PK, full thickness) and lamellar keratoplasty (partial thickness, e.g., DSEK, DMEK).
Why Do Corneal Transplant Costs Vary in India?
Costs range from ₹50,000 to ₹2 lakh per eye:
- Procedure Type: PK (₹50,000–₹1 lakh); DSEK/DMEK/DALK (₹1–2 lakh, more advanced).
- Hospital/Location: Higher in metro cities (Apollo, Fortis); lower in government hospitals (AIIMS, ₹10,000–₹30,000; often subsidized under schemes like Ayushman Bharat).
- Surgeon’s Expertise: Experienced corneal surgeons charge more.
- Additional Costs: Pre-op tests (₹5,000–₹10,000), donor cornea (₹10,000–₹20,000, often included), post-op medications (₹5,000–₹10,000).
- Insurance: Covered under most plans for medical necessity; confirm with your provider.
Corneal Transplant Procedure
- Before Surgery Evaluation:
- Diagnosis:
- Slit-lamp exam: Assesses corneal thickness, clarity, and extent of damage.
- Corneal topography: Maps corneal shape (e.g., for keratoconus).
- Specular microscopy: Evaluates endothelial cell count (for Fuchs’ dystrophy).
- Visual acuity test: Measures vision impairment.
- Blood tests: Blood sugar, infection screening (e.g., hepatitis, HIV) for donor-recipient safety.
- Donor cornea: Sourced from eye banks (e.g., LV Prasad Eye Institute in India); tested for infections and quality.
- Medications: Stop blood thinners (e.g., aspirin) 5–7 days prior if safe; antibiotic eye drops (e.g., moxifloxacin) 1–2 days pre-surgery.
- Consent: Risks, including graft rejection, are explained.
- Diagnosis:
- Surgical Techniques:
- Penetrating Keratoplasty (PK):
- Full-thickness transplant, lasting 1–2 hours, under local or general anesthesia.
- The entire cornea is removed using a trephine (circular cutting tool).
- A matching donor cornea is sutured in place with fine nylon sutures (10-0, often 16–24 sutures).
- Used for conditions affecting all corneal layers (e.g., severe keratoconus, scarring).
- Lamellar Keratoplasty:
- Descemet’s Stripping Endothelial Keratoplasty (DSEK):
- Replaces only the inner endothelial layer, lasting 1–1.5 hours.
- A thin layer of donor cornea (endothelium + Descemet’s membrane) is transplanted.
- Used for endothelial disorders (e.g., Fuchs’ dystrophy, bullous keratopathy).
- Descemet’s Membrane Endothelial Keratoplasty (DMEK):
- More advanced, replaces only the endothelium and Descemet’s membrane.
- Better visual outcomes than DSEK but technically challenging.
- Deep Anterior Lamellar Keratoplasty (DALK):
- Replaces outer and middle layers, preserving the endothelium, lasting 1–2 hours.
- Used for keratoconus or scarring sparing the endothelium.
- Descemet’s Stripping Endothelial Keratoplasty (DSEK):
- Intraoperative Tools:
- Trephine: Cuts the cornea (PK, DALK).
- Air bubble: Positions donor tissue (DSEK, DMEK).
- Operating microscope: Enhances precision.
- Penetrating Keratoplasty (PK):
- After Surgery:
- Observation: 1–2 days in hospital (PK); same-day discharge (DSEK/DMEK).
- Eye care: Antibiotic/steroid drops (e.g., prednisolone, moxifloxacin) for 6–12 months to prevent infection and rejection.
- Pain management: Mild discomfort managed with acetaminophen.
- Instructions: Avoid rubbing the eye, heavy lifting, or water exposure for 4–6 weeks; wear an eye shield at night.
Recovery After Corneal Transplant
- Hospital Stay: 1–2 days (PK); same-day discharge (DSEK/DMEK).
- Post-Surgery Care:
- Vision: Gradual improvement; PK takes 6–12 months for stable vision (sutures removal); DSEK/DMEK improves in 1–3 months.
- Activity: Avoid heavy lifting, bending, or strenuous activity for 4–6 weeks; normal activities (e.g., reading) in 1–2 weeks.
- Eye care: Use prescribed drops (antibiotic/steroid) for 6–12 months; avoid water, dust, or rubbing the eye for 6 weeks.
- Discomfort: Mild irritation or foreign body sensation for 1–2 weeks; managed with drops.
- Glasses/Contact lenses: Often needed post-PK for astigmatism; prescribed after 3–6 months.
- Follow-Up:
- Visits at 1 day, 1 week, 1 month, then every 3–6 months for 1–2 years to monitor rejection.
- Suture removal (PK): 6–12 months, depending on healing.
Most resume normal activities in 4–6 weeks; full visual recovery takes 6–12 months (PK) or 1–3 months (DSEK/DMEK). Success rate: 90–95% achieve improved vision (if no other eye conditions); graft survival 80–90% at 5 years.
Risks and Complications
- Surgical Risks:
- Infection (1–2%): Endophthalmitis or keratitis; treated with antibiotics, may lead to graft failure.
- Bleeding (1–2%): Usually mild; rare severe hemorrhage.
- Graft rejection (10–20% in PK, 5–10% in DSEK/DMEK): Signs include redness, pain, vision loss; managed with steroids, may need repeat transplant.
- Post-Surgery:
- Graft failure (5–10%): Due to rejection, infection, or poor donor quality; requires repeat surgery.
- Astigmatism (20–30%, PK): Irregular corneal shape; managed with glasses, contact lenses, or suture adjustment.
- Raised intraocular pressure (5–10%): Temporary or glaucoma; managed with drops.
- Corneal edema (5–10%): Persistent swelling; may need repeat transplant (esp. DSEK/DMEK).
- Long-Term:
- Cataract (10–15%): Accelerated by surgery or steroids; may need cataract surgery later.
- Retinal detachment (<1%): Rare; causes sudden vision loss; needs urgent surgery.
Report sudden vision loss, severe pain, redness, or discharge promptly.
Frequently Asked Questions (FAQs)
What causes corneal damage requiring a transplant?
Keratoconus, infections (e.g., herpes), dystrophies (e.g., Fuchs’), trauma, or complications from prior eye surgery.
Can I avoid a corneal transplant?
Yes, for early keratoconus: Glasses, contact lenses, or corneal cross-linking (CXL); advanced cases or severe scarring/edema require transplant.
Is keratoplasty painful?
No, performed under anesthesia; mild discomfort post-surgery for 1–2 weeks, managed with medication.
How soon can I resume activities?
Light activities in 1–2 weeks; normal routines in 4–6 weeks; full recovery in 1–12 months, depending on the procedure.
Is keratoplasty covered by insurance in India?
Yes, under most plans for medical necessity; confirm with your provider.
Signs of complications?
Sudden vision loss, severe pain, redness, or discharge.
Will I need glasses after surgery?
Often, esp. with PK (astigmatism); DSEK/DMEK may require less correction; prescribed after 3–6 months.
Lifestyle changes post-surgery?
Avoid rubbing the eye, use prescribed drops, wear sunglasses for UV protection, avoid contact sports, and attend regular follow-ups.
Conclusion
Keratoplasty is a highly effective procedure to restore vision or relieve pain in patients with corneal damage, with a good success rate and improved quality of life. India’s top hospitals (Apollo, Fortis, AIIMS) provide affordable, expert care, often supported by insurance or government schemes. Understanding the procedure, costs, recovery, risks, and FAQs helps patients approach surgery confidently. Consult an ophthalmologist for personalized guidance and optimal outcomes.
Looking for Best Hospitals for Corneal Transplant
Note: we are not promoting any hospitals
we are not promoting any hospitals we sourced all the details from google and hospitals website, please verify and start with your surgery here we go the list includes government, budget and superspeciality hospitals accreditation bodies are the National Accreditation Board for Hospitals and Healthcare Providers (NABH) and the Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₹) | Maximum Price (₹) |
|---|---|---|
Agra |
40,000 |
1,50,000 |
Ahmedabad |
60,000 |
2,50,000 |
Ajmer |
40,000 |
1,50,000 |
Aligarh |
40,000 |
1,50,000 |
Allahabad |
40,000 |
1,50,000 |
Amritsar |
50,000 |
2,00,000 |
Aurangabad |
50,000 |
2,00,000 |
Bangalore |
60,000 |
2,50,000 |
Bareilly |
40,000 |
1,50,000 |
Belgaum |
50,000 |
2,00,000 |
Bhopal |
50,000 |
2,00,000 |
Bhubaneswar |
50,000 |
2,00,000 |
Bikaner |
40,000 |
1,50,000 |
Chandigarh |
60,000 |
2,50,000 |
Chennai |
60,000 |
2,50,000 |
Coimbatore |
60,000 |
2,50,000 |
Dehradun |
50,000 |
2,00,000 |
Delhi |
60,000 |
2,50,000 |
Dhanbad |
40,000 |
1,50,000 |
Durgapur |
40,000 |
1,50,000 |
Faridabad |
60,000 |
2,50,000 |
Ghaziabad |
60,000 |
2,50,000 |
Gorakhpur |
40,000 |
1,50,000 |
Guntur |
50,000 |
2,00,000 |
Gurgaon |
60,000 |
2,50,000 |
Guwahati |
50,000 |
2,00,000 |
Gwalior |
40,000 |
1,50,000 |
Hyderabad |
60,000 |
2,50,000 |
Indore |
50,000 |
2,00,000 |
Jabalpur |
40,000 |
1,50,000 |
Jaipur |
60,000 |
2,50,000 |
Jalandhar |
50,000 |
2,00,000 |
Jamshedpur |
50,000 |
2,00,000 |
Jodhpur |
40,000 |
1,50,000 |
kanpur |
40,000 |
1,50,000 |
Kochi |
60,000 |
2,50,000 |
Kolkata |
60,000 |
2,50,000 |
Kollam |
50,000 |
2,00,000 |
Lucknow |
50,000 |
2,00,000 |
Ludhiana |
60,000 |
2,50,000 |
Madurai |
50,000 |
2,00,000 |
Mangalore |
50,000 |
2,00,000 |
Meerut |
40,000 |
1,50,000 |
Moradabad |
40,000 |
1,50,000 |
Mumbai |
60,000 |
2,50,000 |
Mysore |
60,000 |
2,50,000 |
Nagpur |
50,000 |
2,00,000 |
Nashik |
50,000 |
2,00,000 |
Navi Mumbai |
60,000 |
2,50,000 |
Noida |
60,000 |
2,50,000 |
Patna |
40,000 |
1,50,000 |
Pune |
60,000 |
2,50,000 |
Raipur |
50,000 |
2,00,000 |
Rajkot |
50,000 |
2,00,000 |
Ranchi |
40,000 |
1,50,000 |
Surat |
60,000 |
2,50,000 |
Thane |
60,000 |
2,50,000 |
Vadodara |
50,000 |
2,00,000 |
Varanasi |
40,000 |
1,50,000 |
Visakhapatnam |
50,000 |
2,00,000 |
Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.