Keratoplasty KDAH Indore

A Keratoplasty is usually performed to restore vision in a patient with damaged cornea. A Keratoplasty also helps relieve pain or other symptoms linked with corneal diseases. Following are some conditions that can be treated with a Keratoplasty:

• A genetic condition called Fuchs dystrophy.
• A cornea that bulges outward, called keratoconus.
• Tearing or thinning of the cornea.
• Cornea scarring, caused by infection or injury.
• Corneal swelling.
• Complications caused by previous eye surgery.
• Corneal ulcers not responding to medical treatment.

Risks of Keratoplasty

Even though Keratoplasty is a safe procedure, some risks of serious complications are associated with the procedure, including:

• Pressure increases within the eyeball, called glaucoma.
• Eye infection.
• Rejection of the donor cornea.
• Problems with the stitches used to secure the donor cornea.
• Retinal problems, such as retinal detachment or swelling.
• Bleeding.

The immune system of the body can attack the donor cornea mistakenly, which manifests in the form of rejection. Rejection may require another cornea transplant or medical treatment. You must make an urgent appointment with your ophthalmologist if you experience symptoms like eye pain, vision loss, sensitivity to light, and red eyes.

Before the procedure, you will undergo:

• Thorough eye examinations
  Your ophthalmologist checks for conditions that may give rise to complications post-surgery.
• Eye measurements
  Your ophthalmologist determines the size of donor cornea that is suitable for you.
• A review of all supplements and medications you are taking
  You might be required to stop taking some of your supplements and medications before or after Keratoplasty. So, you must share complete drug history with your doctor.
• Treatment for other ophthalmological conditions
  Unrelated ophthalmological problems like swelling or infections can decrease your chances of a successful Keratoplasty. Your ophthalmologist will treat those conditions prior to the surgery.

Finding a donor cornea

Cornea used in Keratoplasty procedure is collected from dead people. Those who died from unknown causes are not a candidate for Keratoplasty. Corneas from people with eye disease or certain conditions like diseases passed from one generation to the next and previous eye surgery are not used.

Operations to transplant a portion of the cornea

A Keratoplasty or cornea transplant is aimed at removing either partial thickness or the entire thickness of the diseased cornea and replaces it with healthy donor tissue. Your surgeon will decide on which method to use. Operations of this type include:

• Penetrating keratoplasty
  This procedure involves a full-thickness cornea transplant. The surgeon cuts through the whole thickness of the diseased or irregular cornea so that a small button-sized disk of corneal tissue. A precise circular cut is made with a special instrument. The donor cornea is placed in the opening. Then, your surgeon uses sutures to hold the new cornea in place. The stitches might be removed later after having an appointment with your ophthalmologist.
• Endothelial keratoplasty
  Endothelial Keratoplasty is of two types. These procedures are used to remove the diseased tissue from the corneal layers that lie at the back. The layers include endothelium and Descemet membrane, which is attached to the endothelium. The removed tissue is replaced by the donor tissue. The first type of operation known as Descemet stripping endothelial keratoplasty (DSEK), employs donor tissue to replace one-third of the cornea.
• Another type of operation known as Descemet membrane endothelial keratoplasty (DMEK) employs a much thinner layer of donor tissue. The tissue used in this procedure is extremely thin and fragile. This operation is more difficult than DSEK but it is used commonly.
• Anterior lamellar keratoplasty (ALK)
  Two different methods are employed to remove disease tissue from the front layers of the cornea, including the stroma and the epithelium. However, the back layer of the endothelial is back in place. The depth of cornea damage helps find out the type of ALK operation that is most suitable for you. Superior anterior lamellar keratoplasty (SALK) is used to replace only the front corneal layers. This leaves the endothelium and healthy stroma intact.
• A deep anterior lamellar keratoplasty (DALK) is an operation that is used when the damage to the cornea expands into the deeper stroma. Healthy donor tissue is then attached to replace the removed cornea part. This process is referred to as grafting.
• Artificial cornea transplant
  If you are not a candidate for a corneal transplant, you might be selected for an artificial cornea. This procedure is referred to as keratoprosthesis. Your healthcare provider will discuss which corneal transplant surgery method is best suited for you, let you know what to expect during the operation and explain the risks of the procedure.

During the procedure

On the corneal transplant surgery day, you will be given medication to calm you down and make you less anxious. You might also be given a medicine that makes your eye numb and make you experience less pain. Surgery is performed on one eye at a time. The time spent in surgery depends on your situation.

After the procedure

After your cornea transplant, you can expect to:

• Receive medications
  Eye drops and other medications can help control swelling, infection, and pain. Eye drops as immunosuppressant are used so that the risk of corneal rejection is prevented.
• Wear eye protection
  Glasses or eye shields are used to protect the eye while it is healing.
• Lie on your back
  Based on the type of transplant, you might need to do this post-surgery. This helps the new tissue to stay in place.
• Avoid injury
  After your corneal transplant surgery, plan to take it easy. When your ophthalmologist approves, work your way up gradually to perform activities like exercise. Don’t press or rub on your eye. You will be required to take extra precautions to avoid harming your eye for the rest of your life.
• Return for frequent follow-up exams
  You will have you visit your ophthalmologist regularly for upto a year after the corneal transplant surgery. This is done to monitor your progress and check for complications.

Results

Most patients receiving a corneal transplant will have their vision restored at least partially. After your corneal transplant, what you can expect depend on your reason for taking the surgery and your overall health. Your risk of developing complications like corneal rejection continues for years post-cornea transplant. So, you will need to see your ophthalmologist regularly. Corneal rejection can often be managed with medications.

Vision correction after surgery

Your vision might be worse than before soon after surgery. It is only because your eye requires some time to adjust to the new cornea. However, your vision will improve after some time. Healing of the outer layer of the cornea may take several weeks to months. After it heals, your ophthalmologist will make adjustments to improve vision, such as:

• Correcting unevenness in your cornea
  The stitches that hold the cornea of the donor in place on the eye might cause corneal irregularities. This uneven surface can lead to astigmatism. It can make the vision blurry. Your ophthalmologist may address the condition by releasing some stitches.
• Correcting vision problems. Refractive errors, like farsightedness and nearsightedness can be corrected. Your ophthalmologist may recommend contact lenses, eye glasses, or, in some cases, laser eye surgery.

The Department of Ophthalmology at Kokilaben Dhirubhai Ambani Hospital, Indore offers primary ophthalmological care services, including ophthalmologic checkups and routine and emergency medical and surgical management of a vast range of ophthalmological conditions. Annual ophthalmological exams, consultation for eyeglasses, and referrals for fitting contact lenses are also offered.

Consult the best ophthalmologists in Indore who are highly qualified and have years of experience in the field. Further the team is equipped with the latest state-of-the-art technology and ophthalmologic instruments to perform keratoplasty in Indore.

Comprehensive diagnostic services available include assessment of refractive errors, visual acuity, slit lamp evaluation, tonometry, ophthalmoscopy, gonioscopy, pachymetry, visual field testing, and fundus photography. The typical disorders diagnosed and treated in the department include contact-lens-related problems, blepharitis and dry eye, corneal ulcers, pterygium, herpes zoster and herpes simplex infections, allergic conjunctivitis, cataract, diabetes, glaucoma, macular degeneration, refractive errors like myopia, hypermetropia, and astigmatism, and ocular trauma.