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Renuka.States » Tamil Nadu
CHENNAI, February 4, 2013
Part corneal transplant proves to be a visionary procedure
Ramya Kannan
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Corneal Transplants
TOPICS
health treatment medical procedure/test
pOne eye donor can help not two persons without vision, but now, four
people, thanks to techniques that exist to split each cornea into two
layers, and skilled surgeons, to use these split layers on different
patients. In a scenario where organ shortage is a reality, this also
allows more corneas to be available for transplant.
Click here for a .pdf illustration
Earlier, surgeons were using the entire donated cornea on the
recipient’s eye, making the graft stay with sutures. However, with
advanced equipment, each cornea is now being split into its anterior
and posterior layers, and only the layer appropriate to the diseased
part is being used. For instance, if the lower layer, endothelium, is
damaged, only that layer can be replaced.
Dr. Prashant Garg, Consultant, Cornea and Anterior Segment Services,
L.V. Prasad Eye Institute, Hyderabad, explains that the cornea has
three zones — anterior, middle, deeper —each of them is affected by
different classes of diseases. “Earlier, we were sacrificing healthy
endothelial (posterior segment) cells when the disease was in the
upper zones. We can now treat each zone separately. If the endothelium
is healthy, we don’t have to sacrifice it anymore.”
The endothelium is key, says Bhaskar Srinivasan, consultant, Sankara
Nethralaya. “The most common cause of graft (in corneal transplants)
failure is endothelial rejection. So if the endothelium is healthy, we
will prefer to keep it intact, merely replacing the other parts.”
Additionally, there are more advantages too: smaller incisions,
avoidance of seizures, and, thereby, complications, better recovery
for patient. If the endothelium is unhealthy, it is removed and the
anterior segment is retained.
Dr. Garg says L.V. Prasad Eye Institute has also started an eye bank
to provide split cornea for surgeons across the country. Amar Agarwal,
of Agarwal Eye Hospitals, says that the recovery time is quick. A
50-year-old patient, who recently received an endothelial keratoplasty
(the posterior layer was replaced) could actually get back to work
within a week. “This would be impossible in full corneal transplant,
as it would take months,” he says. Additionally, it would take a
skilled surgeon only 15 minutes to perform the procedure.
Not every one can benefit, Dr. Srinivasan explains. Currently, though
the procedure was introduced in India around 2004, it still remains
the surgeon’s decision to go in for part corneal transplant. Of the
total number of transplant procedures, about 30 per cent are now
endothelial keratoplasties.
On 2/4/13, Surendra Salgaonkar) <surendra.salgaonk...@gmail.com> wrote:
> Please: if you can copy the artical, and pest it again, because mobile does
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> Thank you & good luck!
> Surendra Salgaonkar
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