Note how wide these incisions are and how far they extend out to the corneal periphery. The 2nd photo is of a cornea with a transplant. When a corneal transplant is done, only the center 6mm to 8mm of the central cornea is removed. The donor cornea has to be sutured to what remains of the host cornea. In the 2nd photo you can see the sutures joining the donor cornea to the host cornea. The corneal surgeon who referred this patient to me felt that during the transplant surgery the weakened RK cornea would fall apart and that there would not be a healthy reliable host cornea for the donor cornea to adhere to.