piece. Prognosis The prognosis for visual restoration and maintenance of ocular health with corneal transplants is generally very good. Risks for failure or guarded prognoses are multifactorial. The type of transplant, the disease state requiring the procedure, the health of the other parts of the recipient eye and even the health of the donor tissue may all confer a more or less favorable prognosis. The majority of corneal transplants result in significant improvement in visual function for many years or a lifetime. In cases of rejection or transplant failure, the surgery can generally be repeated. Alternatives Contact lenses Different types of contact lenses may be used to delay or eliminate the need for corneal transplantation in corneal disorders. Phototherapeutic keratectomy Diseases that only affect the surface of the cornea can be treated with an operation called phototherapeutic keratectomy (PTK). With the precision of an excimer laser and a modulating agent coating the eye, irregularities on the surface can be removed. However, in most of the cases where corneal transplantation is recommended, PTK would not be effective. Intrastromal corneal ring segments In corneal disorders where vision correction is not possible by using contact lenses, intrastromal corneal ring segments may be used to flatten the cornea, which is intended to relieve the nearsightedness and astigmatism. In this procedure, an ophthalmologist makes an incision in the cornea of the eye, and inserts two crescent or semi-circular shaped ring segments between the layers of the corneal stroma, one on each side of the pupil. Intrastromal corneal rings were approved in 2004 by the Food and Drug Administration for people with keratoconus who cannot adequately correct their vision with glasses or contact lenses. They were approved under the Humanitarian Device Exemption, which means the manufacturer did not have to demonstrate effectiveness. Corneal collagen cross-linking Corneal collagen cross-linking may delay or eliminate the need for corneal transplantation in keratoconus and post-LASIK ectasia. Epidemiology Corneal transplant is one of the most common transplant procedures. Although approximately 100,000 procedures are performed worldwide each year, some estimates report that 10,000,000 people are affected by various disorders that would benefit from corneal transplantation. In Australia, approximately 2,000 grafts are performed each year. According to the NHS Blood and Transplant, over 2,300 corneal transplant procedures are performed each year in the United Kingdom. In the one-year period ending 31 March 2006, 2,503 people received corneal transplants in the UK. History The