keratoprosthesis surgery in Ahmedabad
1. Chemical injury (Alkali or Acid) of the conjunctiva and Cornea
Chemical injury of the conjunctiva and cornea is a true ocular emergency and requires immediate intervention. Chemical injuries to the eye can produce extensive and serious damage to the ocular surface and anterior segment leading to visual impairment and disfigurement. Immediate saline wash is critical in limiting the duration of chemical (Alkali and Acid) exposure. Debridement of necrotic epithelium should be performed as early as possible and if require amniotic membrane grafting is necessary in severe injury. Early treatment ensures the best possible outcome for this potentially blinding condition.
2. SLET / Limbal Stem Cell Transplantation
Simple Limbal Epithelial Transplantation (SLET) is a surgical technique first described by Dr. Sangwan in 2012 for the treatment of limbal stem cell deficiency (LSCD). The causes of LSCD are chemical or thermal injuries, iatrogenic (topical Mitomycin C, large ocular surface surgeries, etc), contact lens wear, immunologic diseases (Steven Johnson’s Syndrome, TEN syndrome, Ocular Cicatricial Pemphigoid), etc
3. Artificial Cornea Transplant / Keratoprosthesis surgery
Artificial cornea (Keratoprosthesis (K-pro)) is an option for transplant patients who cannot
tolerate a human donor cornea. One of the advantages of an artificial cornea is that it can help
restore vision in patients who are not good candidates for a living corneal transplant from a
human donor. Some indications for K-pros include:
- Multiple previous graft failures
- Severe ocular surface disease, such as after chemical burns, Stevens Johnson syndrome, limbal stem cell deficiency, congenital aniridia, or severe dry eyes.
4. Ocular Surface Tumors / OSSN:
Ocular surface squamous neoplasia (OSSN) encompasses a wide and varied spectrum of disease involving abnormal growth of dysplastic squamous epithelial cells on the surface of the eye. The use of topical chemotherapeutic agents, including Interferon-α2b, mitomycin C and 5- fluorouracil, has the advantage of treating the entire ocular surface and avoiding surgical complications such as positive margins, scarring, and limbal stem cell deficiency. A no touch technique is used during excision of OSSN lesions and should be excised with at least 3-4mm uninvolved conjunctival margin with cryotherapy.