Our Services - Corneal Diseases
The Department of Ophthalmology provides a wide range of treatment options for various corneal diseases. Over the past few years, wide-ranging treatments have been introduced to manage difficult and complicated cases of corneal diseases.
Treatment for Keratoconus
1. Corneal Collagen Crosslinking
This surgery was introduced in 2009 for the treatment of keratoconus. Since then, hundreds of patients have already benefited from this procedure and have their condition stabilised without the need of corneal transplantation. Our technology has also been ungraded recently to achieve faster and more stable results.
2. Intracorneal Stromal Rings (ICRs) Implantation
Intracorneal stromal rings have been provided for the treatment of keratoconus since 2009. While the cornea can be stabilised using collagen crosslinking technology, Implantation of stromal rings can reduce the keratoconus-induced irregularities and thus improve vision.
3. Topographically Guided Surface Ablation
This technology has been developed to treat corneal irregularities. It has also been used in patients with keratoconus. Under the guidance of “corneal maps”, laser is transmitted to specific locations to reduce corneal irregularities. It is effective in treating corneal scars and corneal irregularities caused by other diseases or traumas.
We offer all types of corneal transplantation with an option to apply donor tissue from overseas eyebank, thereby greatly reducing the waiting time for surgery.
1. Penetrating Keratoplasty
Penetrating Keratoplasty involves the removal and replacement of all layers of corneal tissues. During the procedure, a circular cutting device is used by surgeon to cut the donor cornea and remove a circular disc of cornea. A second device is then used to remove a similar sized portion of the patient's cornea. The donor tissue is then sewn in place with sutures.
Penetrating Keratoplasty is now replaced by the technique described below in many situations. It is now reserved for specific disease entity only.
2. Lamellar keratoplasty/Deep Anterior Lamellar Keratoplasty
During this procedure, the anterior layers of the central cornea are removed and replaced with donor tissues. Endothelial cells and Descemets membrane (and part of the stroma in case of Lamellar keratoplasty) are left in place. This technique is used to treat anterior corneal opacifications and scars.
3. Endothelial Keratoplasty
This relatively new procedure has revolutionised the treatment of disorders of the innermost layer of the cornea (endothelium).It replaces the patient's endothelium with a transplanted disc of posterior stroma/Descemets/endothelium (DSEK/DSAEK) or Descemets/endothelium (DMEK). Unlike a full thickness corneal transplant, this surgery can be performed with one or no suture. Patients may recover functional vision in weeks to months as opposed to up to a year with full thickness transplants.
The patient's corneal endothelium is removed and replaced with donor tissue. With DSAEK, the donor tissue includes a thin layer of stroma, as well as endothelium, which is commonly 100–150 µm thick. With DMEK only the endothelium is transplanted. In the immediate post-operative period the donor tissue is held in position with an air bubble placed inside the eye (the anterior chamber). The tissue self adheres in a short period and the air is adsorbed by the surrounding tissues.
4. Artificial Cornea
The Boston Keratoprosthesis (KPro) is the most widely used artificial cornea or keratoprosthesis. It is a treatment option for corneal disease not treatable with corneal transplant techniques mentioned above or for patients with multiple cornea graft rejections.