Keratoplasty at CritiCare Asia Hospitals, Kurla, Mumbai
The cornea is the clear, dome-shaped window at the front of the eye, and light has to pass through it before anything else. CritiCare Asia Hospitals in Kurla is an eye hospital in Mumbai that assesses corneal disease and explains each step of treatment, including costs, before a decision is made. When the cornea turns cloudy or scarred, the image reaching the retina blurs; however healthy the rest of the eye may be, and glasses cannot fix that kind of clouding. If the retina and optic nerve are still working well, a corneal transplant, medically called keratoplasty, can replace the damaged tissue with healthy donor tissue.
When a Cornea Needs Replacing
A cornea can lose its clarity in several ways:
- Infection: a severe corneal infection, whether bacterial, fungal, or viral, can heal into a dense white scar.
- Injury: chemical burns and deep wounds leave lasting damage.
- Keratoconus: the cornea thins and bulges forward, distorting vision. Transplant is usually a later step, once glasses and specialist lenses stop helping.
- Corneal dystrophies: inherited conditions such as Fuchs' dystrophy, in which the cornea slowly clouds over the years.
- Swelling after eye surgery: the cells on the inner surface can fail and let fluid build up.
- A previous graft that has failed, where a second transplant is sometimes needed.
Symptoms of Corneal Damage
Corneal problems do not always announce themselves loudly. Signs that call for an examination by a cornea specialist in Kurla, Mumbai include:
- Hazy or blurred vision that new glasses do not correct
- Glare and sensitivity to light
- Pain, redness or watering, especially after an infection or injury
- A visible white or grey patch on the eye
- Distorted images or glasses that need frequent changes, as in keratoconus
- Vision that is worst on waking and improves through the day, which can happen in Fuchs' dystrophy
Types of Keratoplasty
The cornea has distinct layers, and where possible the surgeon replaces only the part that has failed.
- Penetrating keratoplasty (PK)
the full thickness of the cornea is replaced. It is chosen when damage runs through every layer, as in deep scarring, and the graft is held in place with fine stitches. - Deep anterior lamellar keratoplasty (DALK)
the front layers are replaced, and the patient's own inner layer stays. It suits keratoconus or scars confined to the front, and keeping the inner layer lowers the chance of rejection. - Descemet stripping endothelial keratoplasty (DSEK)
only the innermost layer, which pumps fluid out to keep the cornea clear, is replaced. It is used for Fuchs' dystrophy and for swelling after surgery, and visual recovery is often quicker 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, and since availability cannot be scheduled, surgery may have to happen at short notice. Anyone placed on the list should be ready to come in quickly. The team explains how the donor tissue is arranged and what the process is likely to cost before the patient is registered.
The Procedure of Corneal Transplant Surgery
Before surgery
The examination first confirms that the cornea is the true cause of vision loss and that the retina and optic nerve can make use of a clear graft. Corneal imaging maps the thickness and shape of the cornea. Related problems such as glaucoma, infection, or dry eye are treated or brought under control beforehand. General health is checked, medicines are reviewed, and fasting instructions are given once a date is set, along with what the admission and insurance process involves.
During surgery
The surgeon removes the diseased portion, whether the full thickness, the front layers, or the inner layer, and secures the donor tissue in its place. PK and DALK grafts are stitched. In DSEK, the graft is usually held against the cornea by an air bubble placed inside the eye, and lying face-up for a period afterwards may be advised.
After surgery
A protective shield covers the eye at first. Antibiotic and steroid drops are prescribed, and the steroids are often continued over a long period to keep the graft from being rejected. Rubbing the eye, letting water in, and heavy straining are avoided.
Vision does not clear overnight. It improves gradually and can take months to settle, particularly after a full-thickness graft, where stitches are adjusted or removed at different points. Glasses or a contact lens are fitted once the eye is stable. Follow-up continues for years, not weeks, because a graft needs long-term monitoring.
Risks and rejection
Results vary from patient to patient. The underlying condition, the type of graft and the health of the rest of the eye all affect the outcome, so a clear result cannot be promised. Possible problems include:
- Graft rejection: the immune system reacts to the donor tissue. It can happen months or even years later and, caught early, is usually treated with drops.
- Infection in the graft or the eye
- Raised eye pressure, which may lead to glaucoma
- Graft failure, sometimes needing another operation
- Irregular curvature or stitch-related problems that affect focus
Redness, pain, sensitivity to light, or a drop in vision after a transplant should be reviewed on the same day, not left to the next scheduled visit.
Keratoplasty at CritiCare Asia Hospitals, Kurla, Mumbai
The process starts with finding out whether a transplant is actually needed and which layers are involved. Where other options suit the condition, they are considered first. If surgery is the right route, the ophthalmology team explains the type of graft, how donor tissue is arranged, what recovery involves, what the treatment is likely to cost and what outcome is realistic for that particular eye. Aftercare, including the follow-up schedule and rejection warning signs, is explained before the operation. If a corneal scar, swelling or disease has clouded your vision and glasses no longer help, book a consultation with eye surgeons in Kurla at CritiCare Asia Hospitals.