Corneal Transplant Specialist in Mumbai

Why a corneal transplant may be considered

A transplant is advised when the cornea has lost clarity, shape or structural integrity to a degree that glasses, contact lenses, medication or laser cannot adequately restore — for example advanced keratoconus with scarring, dense corneal scars, corneal swelling from endothelial failure (such as Fuchs dystrophy or after previous surgery), certain infections that have scarred, and some dystrophies.

Types of corneal transplant

Full-thickness transplant — penetrating keratoplasty (PK)

The entire central cornea is replaced with a full-thickness donor graft. PK remains the right choice when disease involves all layers. Visual recovery is slower (sutures often stay for a year or more) and rejection risk is higher than with lamellar techniques. More about PK.

Deep anterior lamellar keratoplasty (DALK)

Only the diseased front layers (epithelium and stroma) are replaced; the patient's own healthy endothelium is retained. Because the inner layer stays, the risk of endothelial rejection is largely eliminated. DALK suits keratoconus and stromal scars with healthy endothelium. Detailed DALK guide.

Endothelial keratoplasty — DSAEK

Only the diseased inner layer (Descemet's membrane and endothelium) is replaced through a small incision, with no large wound and few or no surface sutures. Recovery is much faster than PK. It is used for endothelial failure such as Fuchs dystrophy. Detailed DSAEK guide.

Donor tissue and eye banking

Corneal grafts come from donated human corneas recovered, tested and preserved by licensed eye banks. Donor tissue is screened for transmissible disease according to eye-banking standards. Unlike organ transplants, routine blood-type matching is not required for most corneal grafts.

Preoperative evaluation

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• Complete eye examination including the retina and optic nerve
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• Corneal topography/tomography and pachymetry
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• Endothelial cell assessment where relevant
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• General health review and medication history
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• Counselling on realistic visual goals, recovery time and lifelong follow-up
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The surgery

Corneal transplantation is performed under local or general anaesthesia as a day or short-stay procedure, typically taking one to two hours depending on technique. In PK and DALK the graft is secured with fine sutures; in DSAEK an air/gas bubble supports the thin graft against the back of the cornea.

Recovery and follow-up

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• Vision improves gradually — weeks for DSAEK, many months for DALK and PK as sutures are adjusted or removed.
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• Anti-rejection and antibiotic drops are used for prolonged periods, exactly as prescribed.
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• Shield the eye as advised, avoid rubbing and strenuous activity early on.
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• Follow-up is lifelong; appointments are frequent at first, then periodic.
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Outcomes — an honest view

Corneal transplantation is among the most successful transplant surgeries, but no outcome can be guaranteed. Graft survival depends on the original disease, technique and adherence to follow-up; rejection, infection, astigmatism and (rarely) graft failure can occur, and some eyes need further procedures or repeat grafting. Your surgeon will discuss your individual outlook before surgery.

Long-term care

Protect the eye from injury, never stop steroid drops without advice, report RSVP symptoms immediately, and keep periodic reviews even when vision is good — late rejection and glaucoma are treatable when caught early.

Consultation

Dr. Shraddha evaluates transplant candidates at Sentra Clinic & Hospital, Malad East, Mumbai, including eyes referred for second opinions on technique selection. Request an appointment.

Information on this page is for general education and does not replace an examination, diagnosis or personalised medical advice from a qualified eye-care professional.

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