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LJ Eye Institute - Ambala
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Therapeutic Penetrating Keratoplasty

Therapeutic Keratoplasty (TPK) is a surgical technique where a disease-host corneal tissue is replaced with a healthy donor cornea.

In Numbers

3000+ Total Cornea surgeries performed till time at LJ Eye Institute.

Demographics

Patients from Haryana, Punjab, Himachal Pradesh, J&K, & Rajasthan, trusts LJEI.

Technology / Innovation

LJEI is equipped with all the latest and rare Machines / Technology including AI.

Research

We preserve every single case study to handle any complex situation and publish research papers time to time.

DMEK Surgery in Haryana | Cornea Surgeries in India

Therapeutic Penetrating Keratoplasty Surgery In India

Explain Therapeutic Penetrating Keratoplasty

Therapeutic keratoplasty (TPK) refers to replacing a diseased host cornea with a full-thickness donor corneal tissue to eliminate the infectious disease focus. TPK is routinely performed for non-resolving microbial keratitis such as bacterial, fungal, acanthamoeba, and viral keratitis. TPK, if performed to repair the anatomical defect as perforation or descemetocele, is called tectonic keratoplasty. TPK aims to resolve the infectious foci and restore tectonic integrity with a terminal aim of visual rehabilitation. TPK and tectonic keratoplasty make up significant proportions of corneal transplants performed worldwide, especially in Singapore and other developing nations. In TPK, the host cornea is trephined 0.5-1 mm larger than the infiltrate size, and 0.5 to 1 mm larger donor corneal tissue is prepared. The infected cornea, along with anterior chamber exudates, are removed, peripheral iridectomy is made, and lens removal is done based on the indication, followed by suturing of the donor tissue to the host rim with a 10-0 nylon suture. In the end, peripheral anterior synechia is released, the anterior chamber is formed, and intracameral moxifloxacin is given. The aim is to restore anatomical and functional ocular integrity and eliminate the infective focus. TPK can have multiple intraoperative and postoperative complications. Preoperative antimicrobial therapy reduces the microbial load, and postoperative antimicrobial therapy for 3 or 4 weeks is mandatory to prevent infective sequelae. Steroids are initiated after a brief period of quiescence when the eye is free of infection for graft survival.

Types of Therapeutic Keratoplasty

  • Full-thickness therapeutic keratoplasty
  • Tectonic keratoplasty
  • Patch graft
  • Therapeutic deep anterior lamellar keratoplasty
What are the restrictions after DMEK surgery?
DMEK, DSAEK, and PK patients should avoid heavy lifting and bending past the waist for the first week after surgery. Patients receiving a PK must protect their eye for the rest of their life and avoid any kind of full-contact activities that could result in a direct blow to the eye.
How long does it take for DMEK to heal?
Your eye will take 6-8 weeks to heal. It is normal for your eye to be red, slightly uncomfortable, light sensitive, teary and blurred immediately following surgery. These symptoms will gradually improve within the first 3 weeks.
What are the complications of DMEK surgery?
DMEK carries a risk of postoperative IOP elevation due to pupil blockage caused by the air or gas bubble in the AC, or angle closure due to anterior iris displacement caused by bubble migration to the posterior chamber. A postoperative IOP rise occurs most frequently within the first two hours following DMEK.
DMEK के बाद आप कितनी जल्दी उड़ सकते हैं?
डीएमईके और डीएसएईके के बाद, प्रत्यारोपण ऊतक को जोड़ने के लिए उपयोग किए जाने वाले बुलबुले के कारण बढ़े हुए दबाव से बचने के लिए मरीज़ 2,000 फीट से अधिक की ऊंचाई पर उड़ान नहीं भर सकते हैं या गाड़ी नहीं चला सकते हैं। बुलबुला आम तौर पर इतना बड़ा होता है कि यात्रा को DSAEK के बाद 1 दिन और DMEK के बाद 4-5 दिनों के लिए सीमित कर सकता है।
How long to lay on back after DMEK?
How is the recovery after DMEK surgery? For the first few days after surgery, you will be instructed to lay flat on your back to help the graft attach to your cornea. Our doctors recommend lying flat for 45 minutes out of every hour for the first few days after surgery.
How long is vision blurry after DMEK?
Visual recovery after DMEK/DSAEK takes 1-4 weeks. Typically vision is poor in the first few days due to the air bubble. Vision begins to improve once the bubble is above the level of the pupil.
What are the advantages of DMEK?
DMEK offers significant advantages over other keratoplasty techniques, such as faster visual rehabilitation, better final visual acuity due to minimal optical interface effects, lower risk of allograft rejection, and less long-term dependence on topical steroids.
What is the rejection rate of DMEK?
DMEK. DMEK has a very low rejection rate (mean of 1.9%, range 0% to 5.9%).
How long does the gas bubble last after DMEK?
This gas bubble stays in the eye for 5 days. During this time, the patient will need to lay flat for most of the day.
What size is a DMEK graft?
Comparison of graft diameter in DMEK (8.5 to 9.5 mm), hemi-DMEK (11-12 mm × 5-6 mm), and quarter-DMEK (6 mm × 5 mm)
What are the symptoms of DMEK rejection?
Rejection
  • red eye.
  • sensitivity to light (photophobia)
  • vision problems – particularly foggy or clouded vision.
  • eye pain.
How long does a DMEK transplant last?
Five-year graft survival was similar between DMEK and DSEK. Although DMEK had a significantly lower risk of immunologic rejection, rejection episodes rarely resulted in graft failure within 5 years with either procedure. Sex matching the donor and recipient provided no survival advantage with DSEK or DMEK.

DMEK Surgeons at LJEI

Cornea Surgeon Dr. Vikas Mittal

Dr. Vikas Mittal

Performed 2500+ DMEK Surgeries
20+ Years Experience

Cornea Surgeon Dr. Vikas Mittal

Dr. Neha Jain

Performed 800+ DMEK Surgeries
10+ Years Experience

Indications

Fungal Keratitis

Not improving (refractory) after maximal medical therapy;

Corneal perforation

Scleral involvement

Rapid corneal melt

Descemetocele

Bacterial Keratitis

Descemetocele

Corneal perforation

Limbus to limbus corneal involvement

Corneoscleral abscess

Non-compliance to medications

Resistant to conventional therapy

Pythium Keratitis

Descemetocele

Corneal perforation

Early limbal spread

Peripheral guttering

Corneal melt

Resistant to conventional therapy

Acanthamoeba Keratitis

Descemetocele

Corneal perforation

Severe scleral involvement

Non-resolving keratitis with maximal medical therapy

Viral Keratitis

Herpes simplex keratitis

Herpes zoster keratitis

Secondary bacterial infiltrate with corneal melt

Corneal perforation

Available Cornea Treatments at LJEI

DMEK Surgeries

DSEK Surgeries

We feel proud to say that our doctors train various Cornea techniques to National and International doctors.

Most Advanced Eye Transplant Techniques Available

At LJ Eye Institute we use most advanced Eye Transplant techniques whichever is available in the world, which further help to increase the success rate. Where using traditional techniques the success rate is 70% to 75%, the new techniques increase the success rate to 90% to 95%.These advanced techniques includes DMEK, DALK, DSEK, using such techniques we need not to change whole Cornea and we change only One or required number of layers of Cornea.

Technology @ LJEI

Technology Available For Cornea Treatments at LJEI

LJ Eye Institute employs ultra-advanced technologies for Cornea Transplant procedures.

  • We utilize Femtosecond LASER technology for Cornea Transplants, ensuring precision and accuracy compared to conventional blade methods.
  • Our facility is equipped with specialized equipment including Specular Microscope for assessing corneal power, Topography, Pentacam, Anterion, and OCT for comprehensive evaluation.
  • We integrate the latest available technologies from around the world to achieve the highest success rates in Cornea Transplants.
  • For pediatric cases, we have a dedicated spare system and have extensively researched Pediatric Cornea diseases, with publications in national and international medical journals.
  • LJ Eye Institute is at the forefront of Stem Cell Transplantation, particularly in the pioneering SLET technique, with numerous published papers showcasing our advancements and modifications in the field.

Still Have Questions?

Cornea Patients Feedbacks

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