Other conditions are pseudophakic bullous keratopathy, keratoconus, Fuchs endothelial dystrophy, failed previous corneal transplant and corneal opacification following infection
The ultimate goal of this surgery is to obtain a clear graft.
Comprehensive ophthalmologic examination, complete history of systemic diseases such as collagen-vascular disease and thorough social history prior to keratoplasty are necessary for an optimal surgical result.
Deep corneal vascularization, chronic ocular surface disease and peripheral corneal thinning may worsen the prognosis for PK.
Ocular surface diseases, active anterior segment inflammation, eyelid malposition, lagophthalmos or infection should be identified preoperatively and treated aggressively.
Anterior segment abnormalities such as peripheral anterior synechiae with elevated intraocular pressure or coexistent cataract is commonly managed in concert with penetrating keratoplasty.