Keratoplasty at CritiCare Asia Hospitals, Malad, Mumbai
Every image the eye sees passes first through the cornea, the clear, dome-shaped surface at the front. CritiCare Asia Hospitals in Malad is an eye hospital in Mumbai that follows corneal patients through diagnosis, surgery, and the long years of monitoring afterwards. A cornea that turns cloudy or scarred blurs the picture reaching the retina, even when the rest of the eye is healthy, and glasses cannot correct that. Where the retina and optic nerve still work well, a corneal transplant (keratoplasty) can swap the damaged tissue for healthy tissue from a donor. For older relatives and younger adults alike, the decision is usually made together with family.
When a Cornea Needs Replacing
Several routes lead to a cornea that has lost its clarity:
- Infection: severe bacterial, fungal, or viral infection can heal as a dense white scar.
- Injury: chemical burns and deep wounds cause lasting damage.
- Keratoconus: thinning and forward bulging of the cornea that distorts vision. A transplant tends to come later, when glasses and specialist lenses no longer help.
- Corneal dystrophies: inherited conditions such as Fuchs' dystrophy, where the cornea clouds slowly over years.
- Swelling after eye surgery, when the cells lining the inner surface fail, and fluid collects.
- A graft that has failed, which sometimes calls for a second transplant.
Symptoms of Corneal Damage
A relative may spot these changes before the patient does. They are worth a visit to a cornea specialist in Malad, Mumbai:
- Hazy or blurred sight that glasses do not improve
- Glare and discomfort in bright light
- Pain, redness or watering, particularly after an infection or injury
- A white or grey patch on the eye
- Distorted images, or spectacle numbers that keep changing, as in keratoconus
- Vision that is worst in the morning and clears during the day, which can occur in Fuchs' dystrophy
Types of Keratoplasty
The cornea is made of layers. Whenever possible, only the failed layer is replaced.
- Penetrating keratoplasty (PK)
all layers are replaced. It is used when damage runs right through, such as deep scarring, and the graft is secured with fine stitches. - Deep anterior lamellar keratoplasty (DALK)
the front layers are replaced while the patient's inner layer is kept. It fits keratoconus and scars confined to the front, and keeping the inner layer reduces the risk of rejection. - Descemet stripping endothelial keratoplasty (DSEK)
only the innermost layer, the one that pumps fluid out to keep the cornea clear, is replaced. It is used for Fuchs' dystrophy and swelling after surgery, and sight often recovers faster than after a full-thickness graft.
Donor Tissue and the Eye Bank
Donor corneas come from eye banks, from people who pledged their eyes or whose families consented to donation after death. The tissue is screened and checked before use. Patients are usually registered with the eye bank. Because availability cannot be scheduled, the call for surgery may come at short notice, so it helps if a family member knows the plan and can travel with the patient on the day.
The Procedure of Corneal Transplant Surgery
- Before surgery
The first step is to confirm that the cornea is truly responsible for the vision loss and that the retina and optic nerve can benefit from a clear graft. Corneal imaging maps its thickness and shape. Glaucoma, infection, and dry eye are treated or controlled first. General health is checked, medicines reviewed, and fasting instructions given once a date is fixed. - During surgery
The surgeon removes the diseased part, which may be the full thickness, the front layers or the inner layer, and fixes the donor tissue in place. PK and DALK grafts are stitched. In DSEK, an air bubble inside the eye usually holds the graft against the cornea, and lying face-up for a while afterwards may be advised.
After surgery
A shield covers the eye at first. Antibiotic and steroid drops are prescribed, and steroids are often continued for a long time to guard against rejection. The eye should not be rubbed, water kept out, and straining avoided.
Sight does not clear overnight. It improves slowly and may take months to settle, especially after a full-thickness graft, where stitches are adjusted or removed at different times. Glasses or contact lenses come once the eye is stable. Follow-up carries on for years, because a graft needs long monitoring, and a family member who helps with drops and appointments makes that easier.
Risks and rejection
Outcomes differ between patients. The condition behind the problem, the type of graft and the state of the rest of the eye all play a part, so a clear result cannot be promised. Possible problems are:
- Graft rejection: the immune system reacts to the donor tissue, sometimes months or years later. Caught early, it is usually treated with drops.
- Infection in the graft or the eye
- Raised eye pressure, which may lead to glaucoma
- Graft failure, which may need another operation
- Irregular curvature or stitch-related problems that affect focus
Redness, pain, light sensitivity or a fall in vision after a transplant should be checked the same day.
Keratoplasty at CritiCare Asia Hospitals, Malad, Mumbai
Care starts by establishing whether a transplant is needed at all, and which layers are involved. If other options suit the condition, they come first. Where surgery is right, the ophthalmology team explains to the patient, and to the family if they wish, the type of graft, how donor tissue is arranged, what recovery involves and what outcome is realistic for that eye. Aftercare, including the follow-up schedule and the warning signs of rejection, is explained before the operation, and the same team follows the graft over the years that matter most. If a corneal scar, swelling, or disease has clouded your vision and glasses no longer help, book a consultation with eye surgeons in Malad at CritiCare Asia Hospitals, Malad.