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2211 Bush St. San Francisco, CA 94115
(415) 474-3333
Team Ophthalmologist for the
San Francisco Giants

(415) 474-9090

Corneal Transplant

Penetrating Keratoplasty

This is also known as a full-thickness corneal transplant. This procedure is performed with local and guided anesthesia so there is no pain. During the procedure, all of the layers of the cornea are replaced with a donor human cornea. The new cornea carries little risk of rejection and can last for many years.


Deep Anterior Lamellar Keratoplasty (DALK) is a partial thickness corneal transplant. This procedure preserves the patient’s own inner layer of the cornea (the endothelium). DALK is a safe procedure that reduces the risk of post-operative astigmatism and graft rejection. However, not all patients are candidates for DALK and may require a full-thickness corneal transplant.

Learn more about DALK


Descemet’s Stripping Endothelial Keratoplasty (DSEK) is a transplant of the innermost layer of the cornea (the endothelium). This is utilized most commonly in Fuch’s Dystrophy and other corneal conditions that compromise the endothelium. When this layer is compromised, the pumps that maintain the clarity of the corneal clarity are no longer functional. This causes cloudiness of vision and can cause swelling of the cornea that can be painful.

During this surgery, the innermost layer of the cornea is replaced with a donor. Once the healing is complete, there is a low risk of rejection and improved clarity of vision.


Descemet’s Membrane Endothelial Keratoplasty (DMEK) replaces the small membrane that surrounds the innermost layer of the cornea. DMEK provides quick visual recovery and reduced rates of graft rejection and post-operative astigmatism as compared to DSEK. However, DMEK is not an option for all patients with endothelial corneal disease.