CORNEA

AMELLAR KERATOPLASTY

DEEP ANTERIOR LAMELLAR KERATOPLASTY (DALK)

 

Newer method of corneal surgical procedure for removing the corneal stroma down to Descemet’s membrane. It is most useful for the treatment of corneal disease in the setting of a normally functioning endothelium (innermost layer of the cornea). As the inner layer is retained the body does not recognize the donor tissue, hence there is no risk of rejection, and steroid medications need not be continued for a long duration.

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DESCEMET’S STRIPPING ENDOTHELIAL KERATOPLASTY (DSEK)

 

 

This involves 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. Vision improvement is evident within weeks. No suturing is necessary, and this reduces risk.

 

OCULAR SURFACE RECONSTRUCTION

Amniotic membrane transplantation

 

 

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.

Amniotic membrane can be used as a graft (inlay), patch (overlay) or in multiple layers. If stored at -80°C it should first be warmed up to room temperature 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, Partial Limbal Stem Cell Deficiency (LSCD)

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MODIFIED OSTEO-ODONTO KERATOPROSTHESIS-MOOKP

 

 

We perform a whole range of Corneal Treatment procedures in order to combat a wide range of ailments and issues. These include, but are not limited to:Corneal-Transplant This is a complex operation which involves first excising all the damaged ocular tissue from the eye, before promptly transplanting the inner mucosal lining of the cheek onto the eye’s surface. A canine or premolar tooth with some bone is then promptly extracted and a bolt-shaped appendage is carved from the tooth-bone structure and fitted with a plastic optical cylinder. The tooth-bone-cylinder amalgamation is then implanted within the patients cheek for it to grow a new blood supply system. After about 4 months, the cheek lining over the eye is perforated and the tooth-bone-cylinder device is inserted into the eye. The lining is then closed. Light can now enter the eye through the plastic cylinder, and vision should, ordinarily, be restored.

 

 

PTERYGIUM SURGERIES

 

 

A pterygium is active mass tissue on the surface of the eye that grows over the front of the cornea (the clear window at the front of the eye). A pterygium usually grows very slowly, over many years. It is more common in people who have been exposed to a lot of sunlight during their lifetime.

How surgery works: Pterygium surgery can be performed under local anaesthesia (awake).

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LIMBAL STEM CELL TRANSPLANT

 

 

The origin of the corneal epithelium appears to reside in the cryptsf Vogt, where a population of “immortal” stem cells resides, and possessing enormous potential for clonogenic cell division. These cells, like all stem cells, have inherent properties which enable them to accomplish error-free replication which avoids development of abnormal differentiation and cellular dysfunction.

The absence or malfunction of corneal stem cells is characterized by the loss of proliferative capacity of corneal epithelium, resulting in surfacing of the cornea with “transdifferentiated” conjunctivally-derived epithelium or, in the worst case, failure to resurface at all in the presence of a persistent epithelial defect, with corneal neovascularization and scarring. Such disorders include primary dysfunctions such as aniridia and congenital erythrokeratoderma, and secondary ones (the most common, in which limbal stem cells are destroyed, either traumatically (e.g., alkali burns) or immunologically (e.g., Stevens Johnson syndrome). It is well recognized that simply replacing the cornea through corneal transplantation in these circumstances is almost uniformly unsuccessful. Limbal stem cell grafting has changed all that, but we should emphasize here that, unless the underlying primary problem has been corrected (for example, the constant assault onto the ocular surface from external aggravants, such as sicca syndrome, meibomian gland dysfunction, lagophthalmos, trichiasis, distichiasis, and the “sandpapering” effect of the keratinizated posterior lid margin), limbal stem cell grafting will not be the panacea for such disorders either. However, if one can correct those underlying saboteurs, then limbal stem cell grafting may set the stage for the ultimate visual rehabilitation step (i.e., keratoplasty), once the ocular surface has been re-established with normal, corneally-derived epithelium.

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CORNEAL COLLAGEN CROSS LINKING

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. Very helpful in condition of Corneal Ectasia.