The cornea is a transparent dome-shaped structure covering the front of the eye. It consists of 5 layers, and a recently added 6th layer called Dua’s layer.
The cornea is peculiar in that it does not have any blood supply and hence is the only structure of the eye that can be transplanted.
Traditionally, corneal transplants involved removing the full thickness of the affected person’s cornea, and replacing it with a healthy donor cornea.
With advances in techniques of surgery, now a single cornea can be divided into atleast 2 parts – the front and back being used for different indications.
This is called Lamellar Corneal Surgery. The biggest advantage of lamellar surgeries is that since only a part of the donor cornea is implanted, the chances of rejection are much lesser.
DSEK or Descemet’s Stripping Endothelial Keratoplasty involves replacing the affected endothelium of the patient with a healthy one from a donor cornea. The endothelium is the innermost layer of the cornea. This donor tissue includes the inner layers and a small portion of the stroma (middle layer) of the cornea. This makes the graft slightly thicker.
DMEK or Descemet’s Membrane Endothelial Keratoplasty involves replacing exclusively the damaged Descemet’s Membrane with a thin scroll of only Decemet’s membrane. The tissue is very thin and flimsy and this is an advanced technique which requires expertise of a cornea surgeon. These corneal surgeries are routinely performed at our hospital by our Cornea
Specialist – Dr Kareeshma Wadia.