Is fluctuating vision normal after a corneal transplant?

What's normal

A full thickness graft is stitched into place, and those stitches pull on the cornea. As the wound heals and as sutures are selectively removed, the curve of the cornea shifts, so your prescription shifts with it. Vision can be better one month, softer the next, then better again. That is why published guidance describes suture removal happening in stages, only two at a time, over months.

The Academy says complete vision after PK may take up to one year or longer, and the Cornea Research Foundation of America says visual recovery often takes a year or longer. The Foundation also notes that sometimes the corneal surface stays somewhat irregular, so a contact lens may be needed for the clearest vision.

After DSAEK or DMEK there are few or no sutures, so this kind of suture driven fluctuation is much less of an issue. Early day to day variation while the cornea is still clearing is still common.

Common through the first year after PK, often settling only once the last sutures are out.

When it stops being normal

Fluctuation that trends downward instead of bouncing around, or a clear step down in vision with fog or cloudiness, matches the V in RSVP and needs a prompt call.

Vision changes with pain, redness, or new light sensitivity should be treated as possible rejection until your ophthalmologist says otherwise. Early treatment matters.