Cornea Disease Treatment & Transplantation


Corneal transplantation is a surgery in which healthy corneal tissue from a donor is used to replace a sick cornea and restore vision. First, the cloudy cornea is removed. Then, a clear, healthy cornea from a donor is put in its place and stitched on.

With the improvement of technology, there are now other ways to replace a diseased or scarred cornea other than with the common surgical approach like Penetrating Keratoplasty, also known as full-thickness corneal transplantation.

We are specialists in the following cornea transplantation methods in Singapore:

  1. Lamellar (Partial) Keratoplasty
  2. Anterior Lamellar Keratoplasty
  3. Posterior Lamellar Keratoplasty / Endothelial Keratoplasty

1 / Lamellar (Partial) Keratoplasty

Lamellar (Partial) Keratoplasty involves the replacing of only the diseased parts of the cornea, as long as the disease has not spread to all of the cornea’s layers.

Benefits of Lamellar (Partial) Keratoplasty

Lower risks of rejection and failure: Lamellar (Partial) Keratoplasty procedures have longer graft life and much lower risks of allograft rejection and failure when compared to the traditional Penetrating Keratoplasty surgical technique.

Better visual outcomes: There are less irregularities and instances of astigmatism with Lamellar (Partial) Keratoplasty. From studies conducted, visual outcomes have been demonstrated to be similar to those of Penetrating Keratoplasty.

2 / Anterior Lamellar Keratoplasty

Anterior Lamellar Keratoplasty is performed on those who have conditions affecting the upper section of the cornea, such as:

  • Anterior scars
  • Anterior dystrophies
  • Keratoconus
  • Infectious keratitis
Benefits of Anterior Lamellar Keratoplasty

Lower risks of rejection and failure: When compared to the traditional surgical approach of Penetrating Keratoplasty, Anterior Lamellar Keratoplasty treatments have much lower risks of allograft rejection and graft failure.

Better visual outcomes: Studies have shown that Anterior Lamellar Keratoplasty surgery outcomes are similar to that of Penetrating Keratoplasty. There are also lower incidences of irregularities and cases of astigmatism.

Greater wound strength: Anterior Lamellar Keratoplasty is an extraocular procedure that allows for improved wound strength.

3 / Posterior Lamellar Keratoplasty/Endothelial Keratoplasty

Only the innermost layer of the cornea (endothelium) may be replaced in corneal diseases affecting the endothelium.

Posterior Lamellar Keratoplasty/Endothelial Keratoplasty is performed on those suffering from degenerative conditions such as:

  • Fuch’s endothelial dystrophy
  • Bullous keratopathy

Descemet’s stripping automated endothelial keratoplasty (DSAEK) is used where smaller incisions are used during the surgery. The corneal graft can also be secured without the use of stitches.

Benefits of Posterior Lamellar Keratoplasty/Endothelial Keratoplasty

Better visual outcomes: There are reduced irregularities and issues of astigmatism. Studies have also revealed that the visual outcomes of Posterior Lamellar Keratoplasty/Endothelial Keratoplasty are equivalent to those of Penetrating Keratoplasty.

Faster visual recovery: Posterior Lamellar Keratoplasty/Endothelial Keratoplasty causes less discomfort. The use of semi-automated microkeratomes results in a smoother dissection plane, less interface irregularity, and improved visual outcomes.

No suture-related problems: There are no suture-related complications because the donor graft is connected without sutures.

Greater wound strength: Because posterior Lamellar Keratoplasty/Endothelial Keratoplasty is a less invasive cornea transplant surgery, wound strength is increased.

If a substantial cataract (cloudy lens) exists, it may be removed during the corneal transplant procedure and an intraocular lens implanted.

In most cases, first-time corneal transplants can be performed with no oral immunosuppression; only eyedrop medication is needed. In contrast to other types of organ transplantation, corneal transplantation can be performed multiple times if prior transplants fail. The success rate of repeat transplants, however, decreases with each transplant, and anti-rejection tablets may be used to prevent graft rejection in subsequent transplants.


An artificial corneal transplant is an alternate treatment for eyes that have undergone many failed corneal transplants or eyes with complicated cornea and ocular surface problems. The Boston Keratoprosthesis is a well-established artificial corneal transplant in the world today.

Boston Keratoprosthesis (KPro)

The Boston KPro is an artificial cornea made of clear plastic with tissue tolerance and optical qualities. The Boston KPro can now successfully treat even the most difficult corneal disorders and blinding cornea conditions.

Benefits of Boston KPro

An established artificial cornea implant: The Boston KPro can effectively restore vision in those with severe blinding corneal disorders, including those with high-risk corneal grafts and those who have previously failed corneal transplants and treatment.

In those with severe blinding corneal disorders, the Boston KPro implantation may be the best possible option for recovering long-term vision.


Dr Leonard Ang, the Medical Director and Senior Consultant Ophthalmologist at Lang Eye Centre, is known for treating a wide range of cornea conditions, including severe blinding cornea conditions. Having completed his specialist training in Singapore, he went on to complete advanced training fellowships in cornea and refractive surgery and trained with established cornea and refractive surgeons and stem cell experts at prestigious eye centres around the world, including the University of Pennsylvania School of Medicine in the USA, the Kyoto Prefectural University of Medicine in Japan, and the Massachusetts Eye and Ear Infirmary (MEEI), Harvard Medical School in the USA. Read more about Dr Ang here.