Corneal Transplantation Procedure

Good morning friends.

I’m Dr. Harshavardhan Ghorpade from the department of visual sciences DOVS from Fortis hospital Vashi, Mumbai and Saroj Speciality Eye Clinic Vashi, New Mumbai. I have done my MS. FRCS and I m a cataract, cornea and a refractive eye surgeon practicing here in New Mumbai. You can get back to me on lybrate.com and know more about me.

Today I’m going to talk to you about very interesting topic about recent advances in corneal surgeries. Now first of all let me start by telling you what is cornea. The Cornea is the front surface of the eye, the black thing you see at the center of the eye. It is actually very transparent and the black color comes from behind i.e. from the iris. This transparent structure is responsible for most of our vision. The other organ or other part which is responsible for most of our vision is the lens that lies behind the iris. So the cornea helps us to focus light on the retina which then transmits it to the brain. If this cornea is opaque then the light will not be transmitted and you will not see clearly. As a result of which we need to do something about it and the most important thing is to do is to replace the cornea with another cornea which comes from a donor and, therefore, donation of eyes after death is a very important act because you helped the next person who is blind to see again. But you should remember that while doing a corneal surgery we only replacing the front part of the eye and not the entire eye. So, now talking about the recent advances corneal surgery we thought that only one cornea could be used per person but today we are doing microsurgery in the cornea as well we are dissenting the cornea into multiple parts and therefore one single eye can help three other eyes. How is that? So, we have three parts of the cornea: the front, the middle and the back. The front part is called Epithelium the middle is Trauma and the inner is Endothelium. Periphery to these are stem cells which are called as limbal stem cells. Now if you have one donation we can dissect the cornea into the front and the back part. The back part can be use for replacing the back part of a damaged cornea and this called as DSEK Descemet Stripping Endothelial Keratoplasty which is a surgery where the inner part is replaced. In other cases where you have the front part involved where there is opacity because of say infection then we removed only the front part of the cornea and it is called as DALK Deep Anterior Lamellar Keratoplasty where we use only the front part of the donated cornea and then use the back part to some other person. Now the third part of the cornea is the Limbal stem cells, these limbal stem cells are responsible for growing a new layer on the cornea. however if they are damaged e.g. in acid injuries or alkali injuries or any other chemical injury then they don’t grow and this front part of the cornea gets completely opaque now we need to replace these stem cells from where do we get them. We get them from the other eye if it is normal or we can take it from a donor may be a relative or a dead person. Once you get these stem cells they can then be implanted into the eye which called as stem cell transplant and then they grow back on the surface leading to clear and very crystal clear front surface of the eye. These stem cells are very much important for overall health of the cornea. So as I have discussed the various advances i have now helped us to donate cornea and makes you full use of it for three different persons; the front part, the back part and the stem cells. So what are you waiting for? Go to the eye bank and get yourself registered for eye donation and remember eye donation can only be made after death so you don’t have to worry. After that you make other person see and you will also see the world through them.

Thank you very much.