The outermost layer of the eye is called Cornea. It is one of the essential components of the human eye as it allows the light to enter into the eye for us to have vision. A cornea is generally 12mm in length and 11mm in height. The cornea also contributes towards around 70 percent of the focusing power of the eye. That is the main reason why it is imperative to take care of the corneas.
Refractive problems like myopia, hyperopia, and astigmatism are caused due to a change in the shape of the cornea.
Problems Affecting the Cornea
- Corneal Ulcer
- Corneal Abrasion
- Arcus senilis
- Dry Eyes
- Corneal Degeneration
- It is also acknowledged as corneal grafting and is a surgical process where an impaired or diseased cornea is interchanged by the donated corneal tissue (the graft) in its entirety (penetrating keratoplasty) or in part (lamellar keratoplasty). The graft has been confiscated from a recently expired individual with no known ailments or other factors that might affect the feasibility of the donated tissue or the health of the recipient.
CORNEAL TOPOGRAPHIC ANALYSIS
- At Eyemantra, we offer the newest corneal imaging modalities: the Pentacam Scheimpflug imaging system and the Orbscan slit scanning technology to map and analyze even the earliest cases of keratoconus.
INTRA CORNEAL RING SEGMENTS (KERARINGS)
- Semi soft gas permeable lenses are the backbone of treatment for eyes with keratoconus. This is because such eyes have huge cylindrical errors which cannot be rectified using just glasses.
- To lessen these large cylindrical errors seen in keratoconus, there is a new therapy available; Intacs or KeraRings are specially designed plastic ring segments, which when implanted in the cornea, considerably decrease the cylindrical error and improve the quality of vision.
- Collagen crosslinking might be used in combination with INTACS or toric phalic IOLs. This combination methodology not only seeks to halt the progression of keratoconus but also offers a marvellous improvement in the quality of vision of the keratoconus patient.
- Progressive cases of keratoconus might necessitate corneal transplantation.Eyemantra is an authorized corneal transplantation centre and boasts of a crew of knowledgeable corneal specialists trained from topnotch institutes across India and the world.
CORNEAL COLLAGEN CROSSLINKING
- Corneal collagen crosslinking, CXL or C3R is a comparatively new kind of therapy for keratoconus patients. It encompasses treating the cornea with high concentrations of vitamin B (Riboflavin). This is followed by exposure to UV light. The treatment persuades cross linkage of corneal collagen fibers at the molecular level.
- It also helps in better contact lens fitting in these patients and decreases the need for major surgeries like corneal transplantation.
Cornea Surgery in Delhi at Eyemantra Eye Centre
At Eyemantra Eye Centre, we deal with a lot of problematic corneal cases on a daily basis. We have expert surgeons who have numerous years of experience in dealing with various diseases related to the cornea and their impact on the overall health of a person’s eye.
After the initial discussion with the patient, our doctors evaluate the complexity of the case and suggest a solution as per the situation and the budget of a patient. If there seems to be a need, the patients can go with the option of a cornea surgery to maintain the overall health of the eye as well as to make sure that the infection does not extend to the other parts of the face and body.
Structure of the Cornea
There are five layers of the cornea which have different functions:
Epithelium – Keeps the Eye Healthy
It is the outermost layer of the cornea which means that whatever external objects will come in contact with the eyes, they will have to pass the epithelium. It is made up of regenerative cells which constantly shed and keep regenerating from time to time. It has two primary functions:
- It keeps away the dust, debris, water, bacteria and any other type of problem causing impurities from the eyes.
- Its smooth surface absorbs essential nutrients and oxygen from our tears.
Bowman’s Layer – Protects the Eye
It is also known as anterior limiting membrane and is made up of protein fibers which are called collagen. It is a strong layer that is between the epithelium and the corneal stroma and is built to protect the stroma.
Stroma – Gives a Perfection for Clarity
It is the middle layer of the cornea and contributes towards around 90 percent of the overall thickness of the cornea. It comprises mainly of collagen fibrils and water along with interconnected keratocytes which are used for the repair and maintenance of the cornea. There are 200 to 300 layers of collagen fibrils are arranged in a parallel manner, and this is the main reason that enables the cornea to be entirely transparent.
Descemet’s Membrane – Protects from Infection
It is the fourth layer of the cornea which is quite thin but very strong as it helps protect against any infections or injuries. It is also known as a posterior limiting membrane. It is also made up of collagen fibrils and separates the stroma from the corneal endothelium.
Endothelium – Maintains the Fluids
It is the final layer of the cornea which is in the innermost part. It is made up of mitochondria-rich cells. Bathed by aqueous humor, the endothelium’s primary function is to keep a perfect balance between the fluids flowing in and out of the cornea at all times. It is the layer that comes directly in contact with the iris and pupil of the eye.
Frequently Asked Questions
In advanced cases there is a complete loss of sight and lens becomes pearly white in colour.
If you experience any of the following issues, schedule an appointment with your eye doctor immediately:
- Cloudy or blurry vision
- Double vision (diplopia)
- Fading of colours
- Seeing halos around lights
- An increased sensitivity to glare
- A distortion of vision that makes objects appear as if you’re looking at them through a veil.
Some infants are also afflicted by cataract, which is caused as a result of infections during pregnancy. The disorder can also be a symptom of metabolic disease affecting the body’s processing of carbohydrates, amino acids, calcium or copper among infants and young kids. If left untreated, cataracts might also lead to blindness.
You may go home with an eye pad and shield, or just a shield. The pad can be removed after the first hour. The shield should be worn at night for the first week.
The eye may feel gritty, and sometimes you may experience some mild headache. These symptoms are common. The discomfort should rapidly improve over the next 24 hours. There should be no worsening of your symptoms. If your discomfort or a headache should deteriorate, you should contact your doctor immediately.
Your vision will normally be much better on Day 2. Sometimes there can be some blurring or misting in the eye, but this should improve over the course of the day. If you feel your vision is becoming more blurred, contact your hospital immediately.
If you take part in a sport that risks a poke in the eye, you should discuss returning to these activities with your surgeon before the operation. You should not go swimming for the first 2 to 4 weeks to minimize the risk of infection. When cycling in the first few weeks following surgery, keep your sunglasses on to reduce the impact of dust.
Jobs that are more physically demanding and involve exposure to liquids or dust might require a more graduated return to full activities, but are best discussed with your surgeon.
You may opt to choose for lenses which provide you vision for distance and near. In such cases, dependency on glasses is reduced.
Routine surgery can only correct the spherical component of the eye leaving behind the cylinder power which has to be later corrected by additional prescription glasses.
With advancements in surgical techniques and IOL (artificial lens) designs, today both spherical and cylinder components of the eye can easily be corrected with the highest precision.
The cylinder component in Cataract Surgery can be corrected by three ways
- LRI or Limbal Relaxing Incisions: In this technique, a Femto Laser is used to give highly precise incisions at the periphery of the cornea to induce cylinder correction. Since these incisions are given by a laser, it can only be coupled with a Femto Cataract Surgery.
- Toric Lenses with Verion Digital Axis Marking: Toric lenses are special lenses which have both cylinder, and spherical component build in one lens. Since cylinder axis varies in individual eyes, the lens has to be aligned to the specific axis of the individual. In such cases, even a minor deviation from the original axis can cause significant disturbance in final visual outcomes. Now with the introduction of Verion Digital Axis Marking system, these toric lenses can be aligned with outmost precision, up to 1 degree.
- Toric Lenses with Manual Marking: As discussed above, the final visual outcome in a toric lens depends on how precisely it is aligned to the original cylindrical axis of the eye. Since the manual markings cannot be as precise as digital markings, the manual system may give slightly inferior results compared to the digital system.
Dr. Shweta Jain
“Qualification:MBBS, DNB (Opthal)”
Dr. Rajiv Mohan
“Dr. Rajiv Mohan is a renowned ophthalmologist who has been instrumental in providing quality eye care and education in Northern India, both in private and charitable sectors. He received his medical degree from University College of Medical Sciences, Delhi in 1985 and Masters in Ophthalmology from Karnataka University in 1989. In 1990 he did his advanced medical training in the field of vitreo- retina from England and got his FRCS (Glasgow) in 2002. ”
Dr. Sanjiv Mohan
“Qualification: MBBS from SMS medical college Jaipur
MS from Dharwad university, Belgaum.
Trained for higher surgical training in Scotland U.K for 2 years.
Experience: Dr. Sanjiv Mohan has an experience of over 18 years as an Ophthalmologist”