This is an advanced form of penetrating (full thickness) or lamellar (partial thickness) keratoplasty. Conventional keratoplasty is performed using specialized blades called trephines to prepare the cornea. These blades are limited in that they can produce only a single type of cut. Femtosecond enabled keratoplasty (FEK) utilizes a femtosecond laser to precisely and accurately cut a more complex shape of both the donor and the host tissue so that they fit together like pieces of a jigsaw puzzle. Surgeons can choose the appropriate configuration for the corneal graft depending on the type of disease or opacity present. This produces a stronger union between the old and new cornea, allowing for fewer stitches that can be removed earlier, with less astigmatism and faster restoration of vision in most cases. In this procedure, the surgeon first prepares the patient’s cornea in the laser suite, while the eye bank prepares the donor cornea with identical laser settings. Then, the procedure is completed in the operating room where the donor tissue is sutured into place under sterile conditions. The advantage of this procedure is the cornea is secured using fewer stitches, reducing the amount of induced astigmatism and allowing for better wound sealing and stronger wound healing, earlier suture removal and more rapid restoration of functional vision.