Corneal Surgery

Corneal Conditions

Miss Khanam is a specialist in the diagnosis and treatment of diseases of the cornea, the clear natural window of the eye. These diseases and ailments include corneal scarring, Fuchs endothelial dystrophy, degeneration, Keratoconus, microbial keratitis (contact lens-induced corneal infection), and complications of contact lens wear, dry eyes and pterygium.

 

 

What is Keratoconus?

Keratoconus is a progressive thinning, bulging and weakening of the cornea, the front surface of your eye. It is associated with poor vision in dim light even with prescription glasses or a soft contact lens, as well as sensitivity to light.

 

Keratoconus treatment

 

Corneal Collagen Cross-linking

Corneal collagen crosslinking is where a blue light is applied to the cornea after application of Riboflavin drops. It is very effective at strengthening the cornea and preventing the worsening of keratoconus. It can also reverse some of the effect of keratoconus.

 

 

 

Intrastromal Segment

Advancement of adding corneal segments from donor cornea has revolutionized vision improving treatment options for keratoconus patients. These procedures are referred to as CAIRS (Corneal Allogenic Intrastromal Ring Segments) and Keranatural.

 

 

Fuchs Dystrophy

Fuchs Dystrophy of the cornea is a condition where there is relatively early reduced functioning of the endothelial pumping cells of the eye. Eventually it can lead to clouding of vision that is worse in the morning and it takes progressively longer time to clear during the day. In clinical practice, transplanting the innermost layer of cells of the eye treats it. In clinical trials, injecting stem cells to regenerate the endothelial layer treats it.

 

 

 

DMEK & DSEK

DMEK stands for Descemet Membrane Endothelial Keratoplasty and DSEK stands for Descemet Stripping Endothelial Keratoplasty. DMEK and DSEK are both partial thickness corneal transplants, which replace non-functioning and diseased layers of the cornea.

 

 

DMEK (Descemet Membrane Endothelial Keratoplasty)

DMEK is a partial thickness corneal transplant. DMEK is currently the preferred option for Fuchs’ Dystrophy and pseudophakic bullous keratopathy, where the endothelial pump cells in the inner layer of the cornea is not functioning, leading to water logging of the whole cornea and cloudy vision. As this procedure only replaces the innermost layer of the cornea and other layers untouched, the visual quality and visual recovery is relatively quick. There is a risk of rejection, which continues through life.
 

 

DSEK (Descemet Stripping Endothelial Keratoplasty)

DSEK is also a partial thickness corneal transplant. This procedure is also an excellent option for patients with endothelial dysfunction. DSEK uses a much smaller opening or incision resulting in a more stable wound than a full thickness Penetrating Keratoplasty (PK), therefore less likely to open with injury or trauma.

 

 

FLEK

Femtosecond Laser Enabled Keratoplasty (FLEK) is a precision development in the way Surgeons perform corneal transplants. FLEK is bladeless using an ultra-short pulse and precise infrared laser, which offers advantages over manual cutting of a corneal transplant.

 

 

Pterygium Surgery

With sun and ultraviolet radiation exposure with stem cell damage on the surface of the eye, there can be a raised, wedge shaped growth of the conjunctiva that slowly can grow over the cornea and affect vision and cosmesis.
Pterygium surgery involves removal of the abnormal tissue and stem cell transplantation to prevent recurrence.