CORNEA

 

  • The department offers cutting edge technologies at affordable cost to the patients.
  • Deliver high standards of patient care with latest technologies in Ophthalmology.
  • Always strive develop innovative surgical technologies to bring best possible eye care to the patients.
  • Receives referrals for corneal diseases like Keratoconus, Bullous Keratopathy, Corneal dystrophy and Infectious Keratitis.
  • Latest techniques in Corneal Transplantation like Lamellar Keratoplasty (Deep Anterior Lamellar Keratoplasty and  Endothelial Keratoplasty) are performed with good quality tissues.
  • The Cornea and External Disease Service is dedicated to improving vision, preventing corneal and external diseases of the eye and providing the best patient care available.

Surgical Procedures

  • Corneal Transplantation
  • Keratoprosthesis (Artificial cornea)
  • Ocular Surface Reconstruction
  • Corneal, limbal, and amniotic membrane transplants allow ocular surface reconstruction in severe surface disease
  • Tissue adhesive application to seal corneal perforation
  • Collagen cross linkage with Riboflavin for Keratoconus, post Lasik Ectasia& pellucid margin dystrophy.
  • Repair for CORNEAL tears

Investigation Offered

  • Specular Microscopy- Study of the corneal endothelium (cells that maintain corneal clarity)
  • Pachymetry- Measurement of corneal thickness
  • Corneal Topography (by Orbscan)- Mapping of the cornea
  • Aberrometry- Measurement of the aberrations in the eye
  • Lab Facility for Microbiological Diagnosis

Team – Cornea Department

  • Dr. Purendra Bhasin– Director &  Sr. Consultant
  • Dr. Manoj Saxena– Sr. consultant
  • Dr. Priyanka Bhuvar – Consultant
  • Dr. Bhupesh– Visiting Consultant

Cornea & External Eye Disease Service


What is cornea? 

Cornea is the transparent, dome-shaped tissue covering the front of the eye. It is like the watch glass of a wrist watch. Cornea is a powerful refracting surface and provides about 2/3rd of the eye’s focusing power. It gives us a clear window to look through and is very important for good vision. Diseases of the cornea lead to loss of its transparency, thus reducing the vision. Injury, infection, genetic diseases and malnutrition can affect the functioning of the Cornea. 

What is corneal blindness ? 

The cornea becomes cloudy or warped due to disease, injury or infection. A damaged cornea distorts light as it enters the eye thereby leading to decrease of eye sight. This kind of visual impairment is called corneal blindness. This is the only type of visual impairment that can be treated by corneal transplantation. Corneal problems can afflict anyone at any age. 

What does Cornea Service at Ratan Jyoti Netralaya include? 

The Cornea Service at the hospital is dedicated to the medical and surgical treatment of problems involving the Cornea and ocular surface. 

The clinic caters to the following Cornea & External eye diseases: –

  • Corneal infections
  • Eye allergies involving cornea
  • Ocular surface trauma
  • Dry eye syndrome
  • Ectatic corneal diseases like keratoconus, keratoglobus and pellucid marginal degeneration
  • Pterygium
  • Corneal dystrophies and degenerations

 

Surgical procedures

  • Corneal Transplantation
  • Keratoprosthesis (Artificial cornea)
  • Ocular Surface Reconstruction
  • Corneal, limbal, and amniotic membrane transplants allow ocular surface reconstruction in severe surface disease
  • Tissue adhesive application to seal corneal perforation
  • Collagen cross linkage with Riboflavin for Keratoconus, post Lasik Ectasia & pellucid margin dystrophy.

 

Other Facilities

  • Specular Microscopy- Study of the corneal endothelium (cells that maintain corneal clarity)
  • Pachymetry- Measurement of corneal thickness
  • Corneal Topography (by Orbscan)- Mapping of the cornea
  • Aberrometry- Measurement of the aberrations in the eye

Corneal Transplant 


1. What is a Corneal Transplant? 

A corneal transplant involves replacing a diseased or scarred cornea with a clear, healthy donor cornea. For many individuals, a corneal transplant may be the only hope for vision restoration, and may be necessary when the cornea is cloudy or damaged due to disease, injury, malnutrition or hereditary conditions. 

Cornea Transplant- A clear central area allows light transmission


2. Who can be Cornea Transplant candidate?

Your eye doctor may suggest a corneal transplant for reasons varying from diseases to eye injuries, which can include the following:

  • Scarring from infections, such as eye herpes or fungal, bacterial keratitis.
  • Hereditary corneal diseases or dystrophies
  • Thinning of the cornea and irregular shape (such as with keratoconus)
  • Corneal decompensation due to previous eye surgeries.
  • Complications from LASIK.
  • Chemical burns on the cornea or scars from an eye injury.

Excessive swelling (edema) on the cornea.

Cornea Transplant Procedure


  1. First, you have to register for corneal transplant.
  2. The waiting period for a donor eye vary depending upon the voluntary donation of eye globe.
  3. Typically, corneal transplants are performed on an outpatient basis under local or general anaesthesia, meaning that you will not need hospitalization.
  4. A round, button – shaped section of tissue is removed from your diseased or injured cornea and nearly identical – shaped button from the donor tissue is then sutured into place.

Descemets stripping Automated Endothelial Keratoplasty (DSAEK)

There has been a revolutionary change in the technique of corneal transplantation. Previously the entire cornea was replaced but now a days only the diseased part of the cornea is replaced. This represents a radical departure from the Penetrating Keratoplasty technique in that Endothelial Keratoplasty surgery accomplishes the goal of endothelial replacement without ever touching the surface of the recipient cornea. By eliminating surface corneal sutures and incisions, the advantages of normal corneal topography and faster wound healing were obtained, leading to faster visual rehabilitation and a more stable globe for the patient.

The procedure of stripping of the Desemet’s membrane for endothelial keratoplasty has been popularized as “Descemets Stripping Endothelial Keratoplasty”, or “DSEK”, and has the advantage of being easier for the surgeon to perform, no sutures, early visual rehabilitation, first day clear cornea, less theoretical chances of rejection and of providing a smoother interface on the recipient side for the visual axis Preparation of the donor tissue in endothelial keratoplasty has also been made easier with the utilization of an automated microkeratome( blade) and the addition of this component to the surgical procedure has been popularized as “Descemets Stripping Automated Endothelial Keratoplasty”, or DSAEK”

Important tips on care after surgery


– Do not lift heavy things
– Do not bend so that your head is lower than your waist
– Avoid sleeping on the operated side
– Do not rub operated eye
– Avoid any vigorous activity
– Avoid alcoholic beverages
– Watch television for short periods only 

Recovering From a Cornea Transplant


  1. The total recovery time for a corneal transplant may be up to a year or longer. Initially, your vision will be blurry and the site of your corneal transplant may be swollen and slightly thicker than the rest of your cornea.
  2. Steroid eye drops will be prescribed for several months to help your body accept the new corneal graft.
  3. Stitches may be removed 3 to 12 months post-surgery, depending on the amount of astigmatism resulting from an irregular eye surface.

 

Sight After a Cornea Transplant


Your vision will fluctuate during the first three months following your surgery, so it is advisable to wait for that time period or until all of your sutures have been removed to give an eyeglass prescription . Cornea Graft Rejection—danger signals

Most corneal transplants are successful. Nevertheless, recognizing the warning signs is the best way to prevent corneal transplant rejection. Familiarize yourself with the four main signs by remembering the acronym RSVP:

  • R: Redness
  • S: Sensitivity light
  • V: Vision decreased
  • P: Pain

 

Rejection signs may occur as early as one month or as late as five years after surgery. Should your graft fail, the corneal transplant can be repeated, generally with good results. Still, overall rejection rates increase with the number of corneal transplants you have. 

 

Cornea Clinic Facilities


  • Specular Microscopy.
  • Topography.
  • Pachymetry
  • Haag-Streit Slit Lamp.
  • Keratometry.
  • C3R for Keratoconus
  • Corneal OCT
  • Pterigium Surgery with Auto graft.