Apart from cataract surgery and corneal transplants, Ophthalmologists in this service handle a range of other ocular complications, example: infections on the surface of the eye.
Ophthalmologists at Drishti Eye Hospitals have expertise and experience in laser assisted surgical procedures. The Institute has been providing laser assisted refractive surgeries for many years with extremely successful results.

What is a Corneal Transplant?

Cornea transplantation is a surgery used to replace a damaged cornea with a healthy, donated one. Some surgeries remove the entire cornea, while others only remove a few parts. The surgery is used to treat a few different corneal diseases. It is often the best way to treat infection and save sight. In most cases, the surgery is very successful.
The healthy corneal tissue used for transplantation is supplied by an Eye Bank. Eye Banks work to collect, evaluate, and store donated corneas. Stringent tests are done to ensure the safety of the person receiving the cornea. The Eye Bank verifies the donor’s medical history and cause of death, and performs blood tests to ensure that the deceased person did not have any contagious disease, such as AIDS or hepatitis.

What is Cornea?

• The cornea is the clear, outer layer of the eye.
• The lens bends to focus light onto the retina.
• The retina receives light that has been focused by the cornea and lens.

The cornea is clear to let light into the eye, and curved to focus the light rays onto the retina.
When the inflammation is extensive or severe, oral drugs such as steroids and immunosuppressive drugs are needed. These drugs have potential side effects, but they are often not serious and their effects are reversible, once treatment is discontinued.

Why is the corneal transplant done?

The cornea may be severely damaged by:
• Keratoconus (Forward bulging of the cornea)
• Cornea infection or injuries
• Corneal ulcers (Keratitis)

About the Surgery:

The surgery usually is finished within 1 hour. An anesthetic will be used so patients don’t feel any pain.

Types of Corneal Transplantation Surgery

There are two main types of corneal transplantation surgery:
1. Therapeutic Keratoplasty: for corneal ulcers
2. Penetrating Keratoplasty: for keratoconus

Risks & Complications

Cornea transplant is a serious surgery. Even though it is safe, it does have a low risk of complications, including:
• Eye infection
• Glaucoma
• Problems with the stitches
• Rejection of the donor cornea
Rejection occurs when patient’s body attacks the donor’s cornea tissue. Symptoms of rejection include red eye, sensitivity to light, cloudy vision, and eye pain. Tell an eye doctor right away if you notice these symptoms. With early detection, it can be treated with steroid eye drops.

Preparing for Surgery:

Before Surgery:
1. Get an eye exam from an eye doctor to make sure the surgery is safe
2. Inform the doctor of all the medicines and treatments you are taking
After the Surgery:
• Please take the medicines as advised by the doctor; do not start or stop the medication on your own. If you are on oral steroid therapy and have to undergo any surgery, please inform your doctor. If you have taken oral steroids for more than two weeks, do not stop suddenly, as this could have serious problems.
• Keep your medication where you can see it easily.
• Schedule your medications around your daily routine, like when you wake up in the morning, at meal times or at bedtime.
• If you forget to use your eye drops, use them as soon as you remember, instead of waiting till the next scheduled time. Then get back on schedule for the next dose.
• Watch out for side effects like changes in vision. Inform your doctor immediately about them or on your next appointment. Schedule your check-ups regularly.
• When consulting doctors for other problems, tell them about the medicines that you are using. Eye medications can affect other parts of the body too.

Results

The results will depend on what damaged your cornea. Most people will have at least some vision improvement. It is important that you come for follow-ups to make sure that your eye is healing properly.

FAQs

 

 

After the surgery, will I have any pain or irritation? How long will it take for these side effects to go away?

You will only have a little bit of pain and it should only last for a few days after the surgery. To control the pain, you will take painkillers. In a few cases, the stitches/sutures may break. This will irritate the eye. The sutures may need to be replaced.

How many days will I have to stay in the hospital after the cornea transplant?

This depends on the type of transplant.
• Therapeutic penetrating keratoplasty (TPK): 5 days
• Penetrating Keratoplasty (PKP): 4 days

How many days until my vision gets better?

Vision should get batter within 3 months of the surgery. If your doctor tells you to wear glasses, you will need to wear them for vision to improve.

How many months will I need to take medications?

You will need to take them for at least 6 months. Depending on the doctor’s advice, you may need to continue them past the 6 months.

When do I have to come for a follow-up?

You will need to visit your eye doctor after 1 month, 3 months, and 6 months. Sometimes, the doctor may ask you to come back more frequently.

When can I take a head bath?

When can I take a head bath?

About Corneal Ulcer

Corneal ulcers are a type of inflammation of the cornea. They are typically caused by infection, but can also be caused by injury. With immediate treatment, most ulcers can be treated without vision loss. But if the infection is left untreated or is too severe, ulcers can permanently harm your eyes.

Causes:

• Eye injury
• Dirty contact lenses
• Viruses
• Dirty water

Risk Factors:

• Reduced immunity
• Warm climate
• Corticosteroid eye drops
• Eye injury
• Contact lenses
To reduce the risk of corneal ulcers:
• Do not wear contact lenses while swimming or for longer than recommended
• Always clean lenses properly with the correct solution
• Avoid bathing in rivers or dirty water
The symptoms of the corneal ulcer are:
• Red eyes
• Eye pain
• More tears than normal
• Difficulty opening your eyelid
• More sensitive to light
• Feeling like something is in your eye
• Blurry vision

Treatment for corneal ulcers depends on the cause of the infection. Antibacterial and antifungal eye drops may treat diseases caused by bacteria or fungi. Antiviral eye drops can be used for ulcers caused by viruses. However, these are not a “cure” and the virus may return.
• If your ulcer does not respond to medicine, your doctor may suggest a corneal transplantation

FAQs

 

When will the pain from my ulcer start to decrease?

Once the medication starts healing the ulcer, the pain will start decreasing. Painkiller tablets may also temporarily reduce the pain.

Will I get my vision back?

After the ulcer heals, you may require glasses or surgery to get better vision.

When will the ulcer heal and how long will I have to apply the medicines?

This depends on the size of the ulcer. Larger ulcers take longer to heal. The cause of the ulcer is also important. Fungal ulcers take longer to heal. For the fastest recovery, keep your diabetes under control and apply the eye drops as advised.

When should I come back for a checkup?

Whenever your doctor advises.

When can I take a head bath?

You may take a head bath when the ulcer is completely healed. Your doctor will tell you when it is okay.

Can any surgery be done and if so, will it give me full vision?

Surgery is only used as a last resort. Once the ulcer heals, a surgery may be possible to improve vision. Also, if your ulcer does not heal with medicines, you might have to get a corneal transplantation.

About Dry Eye

Dry eye is an irritating eye condition that occurs when 1) the eyes don’t make enough tears or 2) the tears evaporate more than usual. This makes the eyes dry and red. Treatment can be used to control your symptoms.

Causes:

Dry eye is caused by anything that affects tear production. If too few tears are made, the eyes can become dry. The eyes can also become dry if the tears evaporate too quickly. Dry eye happens for a few reasons:
• Ageing
• Changes in hormone levels
• Exposure to sun, wind, or dry climates
• Contact lenses
• Eye injury
• Other eye diseases
• Abuse of steroid cream
• Diseases that affect the whole body (like rheumatoid arthritis)

The symptoms of the dry eye are,
Most people experience mild symptoms. In a few cases, dry eye can be more painful, with more severe consequences.
• Dry or sore eyes
• Eye redness
• Eyelids stick together when you wake up
• Watering eyes (Your eye may briefly make too many tears to try and fix the dryness)

Both eyes usually show symptoms. If you experience these mild symptoms, visit your eye doctor. They may be able to prescribe something to relieve the irritation. If your symptoms are severe or accompanied by pain and decreased vision, see an eye doctor immediately. This may be a sign that something else is wrong.

Treatment:

To help your eyes make more tears, your doctor may prescribe artificial tears. These tears are applied as eye drops. They control your symptoms by wetting the eyes. Any inflammation may be relieved with skin creams.
If your dry eye is caused by some other disease, like rheumatoid arthritis, it may be necessary to preserve the tears. In these cases, surgery may be used to stop the tears from leaking out of the tear ducts.

About Keratoconus:

Keratoconus is when the surface of the eye bulges out in a cone shape. This happens when the front layer of the eye (the cornea) starts to thin. At first, the bulge may be mild but the condition can get worse over time. It normally affects both eyes.

Causes:

The cause of keratoconus is not known.
Risk Factors:
• Family history of keratoconus
• Rubbing your eyes
• Conditions like retinitis pigmentosa, Down syndrome, hay fever, and asthma
Keratoconus affects about 1 in every 2000 Indians. It is most common in teenagers and young adults in their mid-teens and 20s.

The symptoms of the Keratoconus are:
• Blurry vision
• More sensitive to light and glare
• Frequent changes in spectacle power
• Sudden cloudy vision

One sign of the disease is a bulging cornea. This bulge causes near-sightedness and astigmatisms. In more serious cases, it can also cause swelling and scarring of the eye tissue. See an eye doctor if you have any sudden changes in your eyesight.

Treatment:

In the early stages, vision can be corrected with spectacles.
In later stages, an individually-fitted hard contact lens must be used. This lens gives better vision. However, it can also increase your sensitivity to light and glare. Finding a comfortable lens can be difficult, but it is important that the lens fit well. Poorly fitting lenses can damage the cornea even more.
If you cannot wear contact lenses or have corneal scarring, your doctor may suggest a cornea transplant.
Another option is corneal cross-linking (also called C3-R). This treatment is new and non-invasive. It works by increasing the strength of the cornea. This may not fix the existing bulge, but it can stop it from getting worse.

About Pterygium:

A pterygium is a pinkish, triangle shaped tissue that grows on the surface of the cornea. It starts at the inner corner of the eye and grows toward the center. Some grow slowly throughout a person’s life, while others may eventually stop. In extreme cases, it can affect vision by covering the pupil of the eye.

Causes & Risk Factors:

The exact cause is unknown. The main risk factor is high exposure to sunlight, sand, and wind. It is more common in men and in adults aged 20-40. To reduce your risk, you should wear sunglasses or hats in areas with direct sunlight.

The symptoms of
Pterygia are visible, triangle-shaped growths on the surface of the eye. They may be white or pink in color.

A pterygium can be removed by surgery. However, this is only recommended if the growth affects vision. The pterygium may affect vision if it covers the pupil or if it becomes irritated by smoke or dust.
A pterygium can be removed for cosmetic reasons. This is not advised because it often grows back. To make it less noticeable, doctors may instead advise eye drops. These reduce irritation and redness.

 

FAQs

Can pterygium be corrected with medication?

No. Surgery to remove the pterygium is the only treatment.

How many days will I have to stay in the hospital after the surgery?

Only 1 day.

Will the pterygium grow back after the surgery?

At Aravind, we do a special surgery using something called “conjunctival autograft”. In this procedure, there is a very low chance that it will grow back.

How many days will I have to apply medication after surgery?

For 3 weeks

When do I have to come for a follow-up?

After 3 weekst.

Will I have full vision after the surgery?

Will I have full vision after the surgery?nt.

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