Corneal graft

Corneal graft: waiting time, cost and recovery

Your question

How long will I wait for a graft, and how long before I see again?

Our answer

The operation is covered and the graft is never billed: donation is free and anonymous. In 2024, half the patients grafted in France were operated within two months of listing, and more than eight in ten within six months. Recovery depends mostly on the technique: a few months after an endothelial graft, considerably longer after a penetrating one.

What you do not pay for

Tissue donation rests on three principles: free of charge, anonymous, consented. The graft is never billed to the patient, and retrieval costs are borne by the hospital that performs it.

As the procedure exceeds €120, the hospital stay is fully covered. What remains is the €32 flat contribution, charged once per stay, the daily hospital charge of €23, and where applicable fee supplements and a private room.

Waiting: what the national figures show

The cornea is the only tissue with a national waiting list, held by the Agence de la biomédecine. Listing by the surgical team is compulsory: no bank releases a graft without it. Two situations take precedence: actual or imminent perforation, and recipients for whom a suitable graft is particularly hard to obtain.

Among patients grafted in France in 2024:

Grafted within	Share of patients
1 month	31 %
2 months	51 %
4 months	72 %
6 months	82 %

The Agence de la biomédecine deliberately publishes no average waiting time, and explains why: listing practices vary too much between teams for an average to mean anything. The figures above describe patients actually grafted during the year, and delays vary by region and by indication. They are benchmarks, not a promise.

The context in 2024: 6,010 grafts performed, 7,727 newly listed patients, 4,521 waiting on 31 December. Demand is growing faster than retrieval, driven by ageing — Fuchs dystrophy now accounts for 42 % of new listings.

Recovery depends on the technique, not the graft

This is what surprises patients most. A ten-year follow-up series in Fuchs dystrophy gives the median time to reach at least 20/40 corrected:

Technique	Median	Rejection at 10 years
DMEK (thin endothelial graft)	≈ 8 months	10 %
DSAEK	≈ 12 months	19 %
Penetrating keratoplasty	≈ 38 months	13 %

The gap is astigmatism. A penetrating graft replaces the full thickness of the cornea and is sutured, and the sutures stay in for twelve to eighteen months; the final spectacle prescription can only be issued after they are removed. An endothelial graft does not change the geometry of the surface, which is why vision returns sooner.

In keratoconus, DALK — which preserves the recipient's own endothelium — markedly reduces the risk of rejection compared with a penetrating graft, since endothelial rejection, the most serious form, becomes impossible.

After surgery

Topical steroid treatment continues for several months, often a year. Eye protection is useful in the first weeks. The risk of rejection is highest in the first two to three years but persists well beyond: a grafted eye is monitored for life, and any episode of redness, pain or blurring must be seen promptly.

Return to work is counted in weeks and depends on the job as much as on the eye: no national reference duration exists for this procedure.

Sources

Updated 26 August 2026