Seeing is Believing

Corneal Grafting Surgeries by BPA Hospital

The Navalbhai  & Hiraba Eye Hospital has been set up by the Blind People’s Association (BPA) in collaboration of the Bareja General Hospital Trust.  The hospital started with comprehensive eye care services to people in 32 villages around Bareja and now we are covering the whole of Gujarat.  The eye hospital has state of the art machinery, equipments and operation theatre for ensuring top quality eye services such as Phaco Machine, Yag Laser, A-scan, B-scan etc, Retina Microscope etc..  It has 50 beds for free patients who are given free food, travel, medicines and surgery.

We are now consistently increasing our quality and quantity through various support and kind donation from well wishers, Philanthropists and different institutions and Corporate groups.  We are doing more than 10,000 surgeries very year which comprise of cataract, glaucoma, pterygium, and other surgeries.

Corneal transplantation, also known as corneal grafting or keratoplasty, is a surgical procedure where a damaged or diseased cornea is replaced by donated corneal tissue (the graft). A cornea transplant replaces diseased or scarred corneal tissue with healthy tissue from an organ donor. The cornea is the transparent front part of the eye that covers the iris, pupil and anterior chamber.  When the entire cornea is replaced it is known as penetrating keratoplasty and when only part of the cornea is replaced it is known as lamellar keratoplasty. Keratoplasty simply means surgery to the cornea. The graft is taken from a recently dead individual with no known diseases or other factors that may affect the chance of survival of the donated tissue or the health of the recipient.

Corneal eye disease is the fourth most common cause of blindness (after cataracts, glaucoma and age-related macular degeneration) and affects more than 10 million people worldwide. We find a lot of corneal scars and injuries in our patients caused by trauma and accidents.

  In general the common causes of corneal opacity which can lead to blindness are:

1.  Scarring from infections, such as eye herpes or fungal keratitis

2.  Scarring from trichiasis, when eyelashes grow inwardly, toward the eye, and rub against the cornea

3.  Hereditary conditions such as Fuchs' dystrophy

4.  Eye diseases such as advanced keratoconus

5.  Thinning of the cornea and irregular corneal shape (such as with keratoconus).

6.  Rare complications from Lasik Surgery

7.  Chemical burns of the cornea or damage from an eye injury.

8.  Excessive swelling (edema) of the cornea.

9.  Graft rejection following a previous corneal transplant.

10.Corneal failure due to cataract surgery complications.

 Once a patient with corneal problems comes to our Hospital, our  eye doctor who specializes in cornea surgery  decides that  if a cornea transplant is the best option for the patient. The patient’s name is  placed on a list at a local eye bank with which we have a tie-up. The patient may  need to wait a few days to weeks for a suitable tissue from a donor eye to become available for a corneal transplant. Before a donor cornea is released for use in transplant surgery, it is checked for clarity and screened for the presence of any diseases such as hepatitis and AIDS, in accordance with the Eye Bank Association of India's strict medical standards and  regulations. Only corneas that meet these stringent guidelines are used in corneal transplant surgery to ensure the health and safety of the graft recipient.

 Corneal  tear

The operated patient needs continuous monitoring for the next two months with regular eye drops and medicines so that the graft is not rejected by the body. For all types of cornea transplant patient will  have to use steroid or antibiotic eye drops daily. These are normally required for several months, although some people may need to use them for more than a year. The drops reduce swelling and inflammation and help prevent infection and rejection.

Unlike other eye surgeries which do not require much follow up, the corneal grafting patients need constant monitoring. At first they need to attend regular follow-up appointments. These should gradually become less frequent over time. If stitches were used to hold the transplant in place, these are initially left in place to allow the cornea to heal. They are usually removed after about a year.

So you can see that this cornea operation is much more complicated and delicate compared to other surgeries.

Hope this info helps to understand the problem even better.

We request our donors to contribute INR 20,000 (US $ 320) to sponsor one cornea grating. Once donor sponsors one such surgery, the hospital provides serviece of pathology, keratoplasty, medicines, hospital stay and follow-up completely free of cost to the person. The complete logistical support is provided by the project. The cornea is availed "free-of-cost" from the Eye Bank.

You are most welcome to support this most humanitarian cause.

Nandini Rawal

Executive Director

(Email: bpaiceviad1@bsnl.in)