Keratoplasty at CritiCare Asia Hospitals, Juhu
The cornea is the clear, dome-shaped window at the front of the eye, and light has to pass through it before anything else. When it turns cloudy or scarred, the image reaching the retina blurs, however healthy the rest of the eye may be, and glasses cannot fix that kind of clouding. If the retina and optic nerve are still working well, keratoplasty, better known as a corneal transplant, can replace the damaged tissue with healthy tissue from a donor. CritiCare Asia Hospitals assesses and treats patients for keratoplasty in Juhu, Mumbai.
When a Cornea Needs Replacing
A cornea can lose its clarity in several ways:
- Infection
a severe corneal infection, whether bacterial, fungal or viral, can heal into a dense white scar. - Injury
chemical burns and deep wounds leave lasting damage. - Keratoconus
the cornea thins and bulges forward, distorting vision. Transplant is usually a later step, once glasses and specialist lenses stop helping. - Corneal dystrophies
inherited conditions, such as Fuchs' dystrophy, in which the cornea slowly clouds over the years. - Swelling after eye surgery
the cells on the cornea's inner surface can fail and let fluid build up. - A previous graft that has failed
sometimes a second transplant is needed.
Consult our eye specialists for a keratoplasty surgery in Juhu, Mumbai at CritiCare Asia Hospitals.
Types of Keratoplasty
The cornea has distinct layers, and where possible the surgeon replaces only the part that has failed.
- Penetrating keratoplasty (PK)
the full thickness of the cornea is replaced. It is chosen when damage runs through every layer, as in deep scarring, and the graft is held in place with fine stitches. - Deep anterior lamellar keratoplasty (DALK)
the front layers are replaced, and the patient's own inner layer stays. This suits conditions like keratoconus, or scars confined to the front, and keeping the inner layer lowers the chance of rejection. - Descemet stripping endothelial keratoplasty (DSEK)
only the innermost layer, which pumps fluid out to keep the cornea clear, is replaced. It is used for Fuchs' dystrophy and for swelling after surgery, and visual recovery is often quicker than after a full-thickness graft.
Donor Tissue and the Eye Bank
Donor corneas come from eye banks, from people who pledged their eyes or whose families consented to donation after death. The tissue is screened and checked before it is used. Patients are usually registered with the eye bank, and because availability cannot be scheduled, surgery may have to happen at short notice. Anyone put on the list should be ready to come in quickly. Consult the best corneal surgeon at our Department of Ophthalmology for further assistance.
The Procedure of Corneal Transplant Surgery
Before surgery
The examination first confirms that the cornea is the true cause of the vision loss and that the retina and optic nerve can make use of a clear graft. Corneal imaging maps the thickness and shape of the cornea. Related problems such as glaucoma, infection or dry eye are treated or brought under control beforehand. General health is checked, medicines are reviewed, and fasting instructions are given once a date is set.
During surgery
The surgeon removes the diseased portion, whether the full thickness, the front layers or the inner layer, and secures the donor tissue in its place. PK and DALK grafts are stitched. In DSEK, the graft is usually held against the cornea by an air bubble placed inside the eye, and lying face-up for a period afterwards may be advised.
After surgery
A protective shield covers the eye at first. Antibiotic and steroid drops are prescribed, and the steroids are often continued over a prolonged period to keep the graft from being rejected. Rubbing the eye, letting water in, and heavy straining are avoided.
Vision does not clear overnight. It improves gradually, and it may take months to settle, particularly after a full-thickness graft, where stitches are adjusted or removed at different points. Glasses or a contact lens are fitted once the eye is stable. Follow-up continues for years, not weeks, because a graft needs long-term monitoring.
Risks and Rejection
Results of corneal transplant vary from patient to patient. The underlying condition, the type of graft, and the health of the rest of the eye all affect the outcome, so a clear result cannot be promised. Possible problems include:
- Graft rejection
the body's immune system reacts to the donor tissue. It can happen months or even years later, and caught early, it is usually treated with drops. - Infection
in the graft or the eye - Raised eye pressure
which may lead to glaucoma - Graft failure
sometimes needing another operation - Irregular curvature
or stitch-related problems that affect focus
Redness, pain, sensitivity to light or a drop in vision after a transplant should be reviewed on the same day, not left to the next scheduled visit.
Keratoplasty at CritiCare Asia Hospitals, Juhu
The process starts with finding out whether a transplant is actually needed, and which layers are involved. Where other options suit the condition, they are considered first. If surgery is the right route, the ophthalmology team explains the type of graft, how donor tissue is arranged, what recovery involves and what outcome is realistic for that particular eye. Aftercare, including the follow-up schedule and rejection warning signs, is explained before the operation. If a corneal scar, swelling or disease has clouded your vision and glasses no longer help, see a cornea specialist in Juhu, Mumbai at CritiCare Asia Hospitals.