Cornea

Cornea

Cornea makes this world beautiful to the person and it also makes person looks beautiful to the world. If it loses it texture and its transparency it become white, the person become blind and also makes him ugly to this world. Cornea and ocular surface department at Trinity Eye Hospital is dedicated to the management of cornea and ocular surface disorders. The department consist of well-trained corneal surgeons and is fully equipped with latest equipments and technology to provide state-of-the-art treatment and care for patients suffering from a wide variety of corneal disorders and infections. The department has an elaborate academic and surgical training programme for post-graduate students and general ophthalmology fellow.

Disease effecting cornea and ocular surface:

Cornea Ocular Surface Microbial infections Ocular surface disorder Allergic eye diseases Ocular surface tumors Corneal dystrophies Stevens Johnson’s syndrome Keratoconus and other corneal degenerations Chemical Injuries Congenital and hereditary corneal disorders Trauma Corneal dystrophies are inherited conditions where patients develop bilateral and symmetrical corneal opacities commonly involving the central cornea. This condition can cause a decrease in vision, as well as symptoms of irritation and watering. Keratoconus is a degenerative disorder of the eye in which structural changes within the cornea makes it thin and change to more conical shape. A “dry eye” is a condition where patients suffer from irritation and discomfort in the eye because of the decreased quantity of tears or increased evaporation of tears from the eye.

Microbial Infections:

Bacterial, viral, fungal and parasitic infections of the cornea may be sight threatening and at times, serious enough to cause loss of the eye. Timely diagnosis of the pathogen and appropriate treatment can help to save the eye and restore vision. Trinity Eye Hospital cornea department is supported by a microbiology laboratory for isolation of the organism.

Chemical Injuries:

Industrial and domestic use of chemicals is widespread. Many patients with acid and alkali injuries to the ocular surface are successfully treated at Trinity Eye. Early and appropriate medical treatment followed by surgical interventions in the form of amniotic membrane grafts and autologous serum, Limbal stem cell transplant.

Cornea Investigations

Specular Microscopy: A Specular Microscope helps to document the health of the corneal endothelium and diagnose early cases of Fuchs endothelial dystrophy. The appropriate management of cataracts with compromised corneas is also helped by specular microscopy. Keeping a track of the endothelial cell count pre and post penetrating keratoplasty is made possible with clinical specular microscopy. Specular microscopy is also important before collagen cross linking and phakic intraocular lens implantation.

Photo slit-Lamp: Documentation of corneal pathology is aided by the Topcon slit lamp with digital camera unit and computer attachment. Tonopen: Intraocular pressure measurement in irregular, scarred, edematous corneas may be more accurately measured with this instrument. While applanation tonometry is still the gold standard for intraocular pressure measurement, tonopen provides a quick and reliable measurement in scarred, irregular corneas and in post penetrating keratoplasty where there may be variable corneal thickness and astigmatism.

Corneal Topography: Trinity Eye Hospital has Pentacam which can evaluate the topography of the cornea as well as measure the corneal thickness. The Pentacam has placido and slit scanning technology which can assist in detecting forme fruste keratoconus, post lasik ectasia, posterior keratoconus. Planned selective suture removal in penetrating and anterior lamellar keratoplasty is made easy with this technology.

Ultrasonic Biomicroscopy (UBM): UBM is an important tool in scarred and hazy corneas. Angle structures, crystalline lens, anterior or posterior chamber intraocular lenses can be visualized in cases where there is no visibility of the anterior segment.

Anterior segment OCT: It used to quantify the thickness of the cornea and to precisely locate the depth of corneal opacity and to see the integrity of descement’s membrane helps in lamellar keratoplasty.

Cornea Facilities

The department offers most recent advances in the field of corneal surgery which include:
  • Descemet’s Stripping EndoKeratoplasty (DSEK) and DMEK Descemet Membrane Endothelial Keratoplasty
  • Lamellar corneal surgeries: Including Deep Anterior Lamellar Keratoplasty (DALK)
  • Automated Lamellar Therapeutic Keratoplasty (ALTK).
  • C3R
  • INTACS
  • POST C3R ICL
  • POST DALK TORIC IOL
  • Corneal tattooing
  • Limbal dermoid excision with partial thickness corneal graft
  • Pterygium excision with autograft
  • Keratoprosthesis

Ocular surface disorders treatment :

Amniotic membrane grafts and limbal cell transplant Corneal tattooing for unsightly scars in non-seeing eyes Pterygium surgery with conjunctival autografts with fibrin glue Corneal collagen crosslinking Sever Dry eye management with punctual plugs- temporary and permanent Management of corneal erosions, recurrent epithelial defects with anterior stromal puncture and PTK EDTA chelation for band shaped keratopathy Bandage contact lens fitting, Research & Teaching activities, Postgraduate teaching: Aims at providing an in-depth knowledge of various corneal disorders and diagnostic procedures to the postgraduate students.