The Cornea is a transparent dome shaped outer surface that covers the front of the eye like a watch glass. Its transparency is of utmost importance to enable the eye to see clearly. The cornea services at CEDS Eye Hospital have specialists trained and skilled in advanced medical and surgical care of patients with cornea and external eye diseases. Our center has programs for patients in whom the cornea has become opaque due to scarring. These are corneal transplants of, penetrating and lamellar type, stem cell transplantation, ocular surface reconstruction with amniotic membrane and mucosal membrane. State-of-art surgical techniques make best use of precious eyes received from the eye bank.
RIBOFLAVIN ASSISTED COLLAGEN CROSS LINKING OF THE CORNEA (C3R)
Corneal collagen cross-linking is a technique which uses UV light and a photosensitizer to strengthen chemical bonds in the cornea, thus enhancing the rigidity of corneal tissue and stabilizing the condition. This treatment is very useful in the management of corneal ectasias and Keratoconus.
PENETRATING KERATOPLASTY (CORNEAL TRANSPLANT))
This is conventionally a corneal transplant wherein the patient’s defective cornea is replaced with a donor’s one. Here, the donor tissue is first prepped and made ready, before the damaged cornea is trephined and removed. The donor tissue is moved into place and then sutured carefully. The sutures are gradually removed as the incision heals.
LAMELLAR KERATOPLASTIES (Deep Anterior Lamellar Keratoplasty or DALK))
This is a newer technique of corneal graftingby which only the anterior part of the corneal stroma down to Descemet’s membrane is removed and grafted. It is most useful for the treatment of corneal disease with a normally functioning endothelium (innermost layer of the cornea). As the inner layer is retained in situ, the body does not recognize the donor tissue, hence there is a far lesser of rejection, and steroid medications need not be continued for a long duration.
LAMELLAR KERATOPLASTIES: (Descemet’s Stripping Endothelial Keratoplasty or DSEK)
This involves the surgical replacement of only the damaged inner layers of the cornea. Rather than replacing the full thickness of the cornea, it replaces just the endothelial cells and Descemet’s membrane. The back layer of the cornea is removed through a small incision on the surface of the eye and replaced with a thin layer of the donor tissue. The rest of the cornea is still healthy and is left intact. It less invasive procedure than a standard corneal transplant so recovery is shorter, just a few months as opposed to a year with conventional penetrating corneal transplants. Vision improvement is evident within weeks. No suturing is necessary, and this reduces risk.
OCULAR SURFACE RECONSTRUCTION (Amniotic Membrane Transplants)
The Amniotic membrane is the innermost membrane lining the amniotic cavity.Amnion and chorion join to form the fetal membrane by the end of the first trimester of pregnancy.
An Amniotic membrane can be used as a graft (inlay), patch (overlay) or in multiple layers. It is therapeutic in conditions like Persistent Epithelial Defects and Neurotrophic Ulcers, Shield Ulcers, Infectious Keratitis, Band Keratopathy, Chemical Burns, Bullous Keratopathy, Photorefractive and Phototherapeutic Keratectomy, Conjunctival Surface Reconstruction, Pterygium and Partial Limbal Stem Cell Deficiency (LSCD)