Lilavati Hospital is performing Corneal Transplantation or Keratoplasty since 2001. It is ably supported by the Roshni Eye Bank, a well developed Eye Bank funtioning since February, 2001. The Eye Bank is fully equipped with state of the art equipments and trained personnel for proper evaluation of donor corneal tissue. Eye banking activities are carried out round the clock to enable timely supply of the corneal tissue to the patients. Till date, Roshni Eye Bank has retrieved more than 2,500 eye balls.
Corneal transplantation or Keratoplasty involves the novel technique of removing damaged or opaque corneal tissue and replacing it with healthy corneal tissue from a human donor. Currently, this is the only scientifically accepted treatment modality for blindness due to corneal diseases also called as corneal blindness.
The various causes of corneal blindness include corneal scar, infections, corneal trauma, corneal damage after cataract surgery, Keratoconus, corneal dystrophy etc.
Keratoplasty could be further classified based on techniques and indications. Full thickness corneal transplantation wherein all the layers of the cornea are transplanted is called Penetrating Keratoplasty or PK. When done to improve vision, it's called Optical Penetrating Keratoplasty. Sometimes, we may need to perform Penetrating Keratoplasty to eradicate severe corneal infection and it's called Therapeutic Penetrating Keratoplasty.
Cornea consists of five layers. Newer technique of Corneal Transplantation involves replacing only the diseased layer and replacing it with a similar but healthy layer of the cornea. This technique is called as Lamellar Corneal Transplantation. Following are the newer techniques in the same.
When we replace the diseased front layers of the cornea, it is called as Deep Anterior Lamellar Keratoplasty or DALK. Various indications for DALK include Keratoconus, corneal scars, corneal dystrophy etc. The advantages of DALK over PK include lesser chances of rejection of donor tissue and faster visual rehabilitation. However, it's a more technically demanding technique.
When the back layers of the cornea are damaged, similar lamellar transplantation can be done and the diseased back layers of the cornea can be replaced with healthy tissue. This technique, called as Descemet Stripping Automated Endothelial Keratoplasty or DSAEK involves transplanting and securing the cornea often without any sutures or stitches. Advantage of DSAEK includes lesser risk of corneal rejection and faster and better visual recovery.
Keratoprosthesis is an artificial device which is implanted in eyes with multiple failed penetrating Keratoplasty. It consists of a PMMA optical cylinder with a back plate which is fitted onto a donor corneal tissue and the entire assembly is then sutured to the donor.