Eye Care Services

Cornea Eye Surgery

What would happen if the cornea is damaged?

How Does The Eye Work?

Anything you see is an image that enters your eye in the form of light. The different parts of your eye collect this light and send a message to your brain, enabling you to see. For perfect vision all the parts of your eye need to work properly

• The cornea is the clear, outer layer of the eye.
• The pupil is an opening that lets light enter the eye.
• The iris, the coloured part of the eye, makes the pupil larger or smaller.
• The lens bends to focus light onto the retina
• The retina receives light that has been focused by the cornea and lens.
• A clear (vitreous) gel fills the inside of the eye, giving it shape.

Clinical Services

The department caters to the efficient diagnosis and management of a wide range of diseases:

• Congential and hereditary corneal disorders
• Corneal and scleral infections
• Ectatic corneal disorders – Keratoconus, Terriens marginal degeneration, Pellucid Marginal
• degeneration
• Immunologic disorders of cornea
• Peripheral ulcerative keratitis
• Ocular surface disorders including severe dry eye, blepharitis, ocular allergies, chemical
• injuries, Stevens Johnson syndrome and ocular surface tumors

The clinic evaluates and treats patients with corneal and external eye diseases including:

Investigations and Diagnostic Services

Corneal Topography (PENTACAM) :-

Evaluates shape and power of the corneal surface. The Pentacam, based on the Schiempflug photography is unique in that it provides invaluable information that other instruments are incapable of measuring.

Pachymetry :-

Measurement of corneal thickness using ultrasound

Aberrometry :-

Measures the optical aberrations of the eye

Specular Microscopy :-

Study of the corneal endothelium (cells that maintain corneal clarity)

Anterior – Segment OCT :-

(Optovue)Helps to identify the depth of corneal scarring/lesions on the cornea, corneal thickness, anterior chamber details and any foreign body in cornea can be investigated.

Meibography :-

Dry eye work up

Anterior segment digital photography :-

Photographic documentation of various corneal conditions for baseline documentation, and monitoring effects of therapy as well as to monitor progression of the disease in any ectatic disorder.

Treatment available at Nandadeep Cornea Clinic :

Customized Laser refractive surgery :-

Various options available which includes PRK, LASIK with microkeratome and femto LASIK (bladeless) SMILE and IPCL.

Collagen cross linking for Keratoconus :-

Procedure performed to stabilize the disease.

Surgeries & Injections & Contact lenses :

The department offers most recent advances in the field of corneal surgery, injection & contact lens which include followings:

• Penetrating Keratoplasty (PK):

  Optical, tectonic and therapeutic with anterior segment reconstruction, combined with SFIOL

• Vitreo-retinal procedures and Paediatric PK
• Lamellar corneal surgeries

  Including Automated Lamellar Therapeutic Keratoplasty (ALTK), Deep Anterior Lamellar Keratoplasty (DALK), Deep Lamellar Endothelial Keratoplasty (DLEK) and Descemet's Stripping Endothelial Keratoplasty (DSEK), Descemet’s Membrane Endothelial Keratoplasty (DMEK).

• Pterygium surgery
• Dry eye analysis & treatment
• Amniotic membrane transplantation:

  used in chemical injuries, ocular surface disorders, etc.

• Mucous membrane grafting
• Glue & BCL for corneal perforations
• Limbal Stem Cell Transplant:

  for chemical injuries etc.

• Injection of Antibiotics in corneal ulcers & anterior chamber
• Avastin injection for corneal vacularization
• Specialised Contact lenses like mini scleral, scleral, rose k – used in disorders like severe dry eye, corneal scar, keratoconus etc.

There are currently an estimated 15 million blind people in India. 6.8 million of these suffer from corneal blindness with vision less than 6/60 in at least one eye, and of these, about 1 million have bilateral corneal blindness. To effectively meet the ever growing demand, we need around 150,000 corneal transplants to be performed every year.

What is the function of an Eye Bank?

What are the various divisions or departments of the Eye Bank?

The Eye Bank is divided into various departments for administrative ease and for ensuring its smooth and proper functioning. The various departments include:

Technical Department:

Its responsibilities include the following functions:

• Tissue Recovery, cornea retrieval
• Processing and distribution
• Preparing tissue for various corneal transplant procedures
• Grading of corneal tissue
• Storage of tissues including cornea, sclera, and limbus
• Distribution of corneas and other tissues to hospitals, clinics and institutions performing corneal transplants, and other surgeries that require donated tissue
• Promotion of research in Eye Banking and transplantation
• Providing space, technology, and tissue for research purposes

Donor Development:

Its responsibilities include the following functions:

• Promotion of awareness about Eye Bank, organ donation through community outreach including television and radio advertisements, hoardings and billboards and public awareness lectures
• Strengthen relationships with the community, hospitals, hospices, and other non-governmental organizations working towards the promotion of eye donation.
• Provide support and grief counselling to donor families during and also after the cornea retrieval.

Quality Control:

• Its responsibilities include the following functions.
• Ensures that proper standards are met during all processes of tissue handling including cornea retrieval, grading, processing and distribution
• Strict adherence to quality standards prescribed by the EBAI, and to ensure cooperation with EBAI during compliance checks

Which part of the eye is stored in eye banks for transplant?

The recovery occurs within hours of the death of the donor. The entire eye, called the globe, may be surgically removed (enucleated), or only the cornea may be excised in-situ and placed in storage media.

Exclusive Facilities:

• 24 hours round-the-clock service.
• Dedicated phone line (24 Hours ) 044-2828 1919
• Direct line to the Manager, Medical Sociology, 044-2822 6694.
• Structured procedure for procurement and corneal button processing with sterile precautions under laminar flow.
• Evaluation of donor tissue by Slit Lamp, Specular Microscopy
• Appropriate serological screening of the donor blood sample.
• Preservation in storage media.A suitable patient is called upon and corneal transplantation surgery is performed as early as possible.

Who can be an eye donor?

Practically anybody from the age of 1 year. There is no upper age limit. People who wear spectacles, who have undergone cataract surgery, diabetics and those who have hypertension can donate their eyes. People blind from retinal or optic nerve disease can also donate their eyes. The ultimate decision about usage for transplantation will be made after evaluation.

Can the next-of-kin consent to a donation if the deceased family member hasn't signed a pledge form?

Yes

How can I be of help on the death of a close relative or friend?

Motivate the next of kin of the deceased person to donate their eyes. Eyes need to be collected within 6 hours of death so call your nearest eye bank at the earliest. You are authorized to donate the eyes of your beloved relatives at the time of their death, even if a pledge for donation has not been made earlier by the deceased.

What should I do till the Eye Donation team arrives?

• Keep the eyes of the deceased closed and cover it with moist cotton.
• Switch off the overhead fan.
• Raise the head end of the body by about 6 inches, if possible - to decrease the incidence of bleeding during the removal of the eyes.
• If possible, instill antibiotic eye drops periodically.

What is the sequence of events in Nandadeep Eye Hospital once I call?

A call for donating eyes sets in motion the Eye Bank machinery and a team is dispatched within 15 minutes. At the site, the eyes of the deceased are enucleated without causing any disfigurement. This procedure takes about 10-15 minutes.

Who cannot be a donor?

• Death from unknown cause.
• Death due to infectious caused viz. Rabies, syphilis, infectious hepatitis, septicemia, AIDS, corona.
• Any frank ocular infection, previous refractive surgery.
• Cancer in any part of the body.

Can the whole eye be transplanted?

No. Only the cornea and sclera can be transplanted. However, the entire eyeball is enucleated, to enable the corneo-scleral disc to be fashioned surgically in a sterile environment.

Can a living person donate his/her eyes?

No

Can the recipients be told who donated the eyes?

No. The gift of sight is made anonymously.