Corneal Transplant Surgery in Mumbai โ Sentra Clinic, Malad East
The cornea โ the clear front surface of the eye โ is responsible for the majority of the eye's focusing power. When it becomes cloudy, scarred, irregular or diseased, vision becomes severely impaired. Corneal transplantation replaces diseased corneal tissue with healthy donor tissue, restoring clear vision. At Sentra Clinic, Malad East, Dr. Rohit Modi (FRCS Glasgow, ICO Fellowship in cornea and anterior segment) performs the full range of corneal surgeries, from advanced lamellar procedures (DALK, DSAEK) to penetrating keratoplasty (PKP) for complex cases.
Corneal transplantation is one of the most technically demanding procedures in ophthalmology, and the surgeon's experience with different graft techniques significantly impacts the outcome. At Sentra, each transplant case is carefully evaluated, the correct procedure is chosen based on which corneal layers are affected, and the post-operative management is meticulous.
๐ฌ Blurry vision from a corneal problem? Get a specialist evaluation.
Conditions Requiring Corneal Transplantation
Keratoconus
Progressive thinning and forward bulging of the cornea causing severe irregular astigmatism and vision distortion. Glasses and soft contact lenses no longer correct vision adequately in advanced disease. DALK (Deep Anterior Lamellar Keratoplasty) is the gold standard โ it preserves the patient's own endothelium, reducing rejection risk.
Fuchs' Endothelial Dystrophy
Gradual failure of the corneal endothelium (inner cell layer) causing corneal oedema and hazy vision. DSAEK (Descemet's Stripping Automated Endothelial Keratoplasty) replaces only the inner two layers โ faster recovery and lower rejection risk than full-thickness transplants.
Corneal Scars
Post-infective scars (after bacterial, viral, or fungal keratitis), chemical or thermal burns, and traumatic scars causing visual axis opacification. Treatment depends on the depth and location of the scar โ superficial scars may be managed with PTK (phototherapeutic keratectomy) rather than transplantation.
Bullous Keratopathy
Painful corneal blistering and oedema following failed cataract surgery, ICL complications or other intraocular procedures. Endothelial transplantation (DSAEK or DMEK) is the treatment of choice.
Corneal Dystrophies
Hereditary, non-inflammatory diseases of the cornea โ including granular, lattice, and macular dystrophies โ causing progressive corneal clouding. Treatment depends on the layer affected and may involve lamellar or full-thickness transplantation.
Failed Previous Graft
Re-grafting (regraft) for rejected or failed corneal transplants. This is technically more complex, and outcomes depend on careful patient assessment and surgical technique. Dr. Modi evaluates each regraft case individually.
Types of Corneal Transplant Procedures at Sentra
DALK โ Deep Anterior Lamellar Keratoplasty
For: Keratoconus, stromal scars, anterior dystrophies. Only the outer layers of the cornea (epithelium and stroma) are replaced, keeping the patient's own inner endothelial cells. Key advantage: rejection of the graft is virtually impossible because the endothelium (the immunologically active layer) is the patient's own. Recovery is slower than DSAEK but long-term outcomes are excellent. Sentra's preferred technique for keratoconus.
DSAEK โ Descemet's Stripping Endothelial Keratoplasty
For: Fuchs' dystrophy, bullous keratopathy, endothelial failure. Only the diseased inner two layers (Descemet's membrane and endothelium) are replaced. The graft is folded and inserted through a small incision, then unfolded and attached with an air bubble. Recovery is faster than PKP (weeks rather than months) with better visual outcomes.
PKP โ Penetrating Keratoplasty (Full-Thickness Transplant)
For: Complex scars, severe disease involving all layers, failed lamellar grafts. The entire cornea โ all 5 layers โ is replaced with donor tissue. PKP offers a clear optical path in complex cases where lamellar techniques are not suitable. Longer recovery (12โ18 months for best vision), and ongoing suture care is required.
Crosslinking (CXL) for Keratoconus โ Non-Surgical Option
For: Progressive keratoconus โ arrest before transplant is needed. Collagen crosslinking uses riboflavin drops and UV-A light to stiffen the corneal collagen and halt keratoconus progression. Early-stage keratoconus patients are ideal. Crosslinking is not a cure โ it prevents worsening โ but can delay or avoid the need for a corneal transplant by years. Offered at Sentra as a routine procedure.
The Corneal Transplant Journey at Sentra Clinic
- Evaluation Visit (1โ2 visits): Slit-lamp examination, corneal topography, specular microscopy (endothelial cell count), OCT anterior segment, best corrected visual acuity, and discussion of surgical options. For keratoconus patients, contact lens tolerance testing and progression documentation are also done.
- Pre-operative Preparation: Blood tests, systemic fitness assessment, consent process with detailed explanation of risks (rejection, infection, astigmatism) and benefits. Donor tissue is sourced from NOTTO-affiliated eye banks.
- Surgery: Performed under local or general anaesthesia in Sentra's OT. Duration: 60โ120 minutes depending on procedure. Inpatient admission for 24 hours.
- Post-operative Care: Steroid eye drops for 12โ24 months, regular slit-lamp checks, suture management (for PKP), and monitoring for rejection. Any sudden redness, pain, or vision drop should be reported immediately โ graft rejection is treatable if caught early.
What Patients Say
"I was 24 with advanced keratoconus and had been told by two hospitals that I needed a full corneal transplant. Dr. Modi evaluated me and said I was still in the stage where crosslinking could halt the progression. I had CXL at Sentra โ my keratoconus has been stable for two years now, no transplant needed. I'm wearing rigid lenses and seeing 6/9. He literally saved my cornea."
โ Rohan Pawar, Kandivali East ยท Keratoconus โ Crosslinking"My mother had Fuchs' dystrophy and her vision had deteriorated badly โ everything was foggy by noon each day. Dr. Modi did a DSAEK procedure. Within six weeks, her cornea cleared dramatically. She can now read with glasses and manages independently. The technical skill involved in a DSAEK is remarkable and we are very grateful to Dr. Modi and the Sentra team."
โ Priya Naidu, Borivali West ยท Fuchs' Dystrophy โ DSAEKSentra Clinic at a Glance
Frequently Asked Questions โ Corneal Transplant
What is the success rate of corneal transplant surgery?
In properly selected patients, DALK for keratoconus has a 5-year graft survival rate of over 95%. DSAEK for Fuchs' dystrophy has similarly high success rates. PKP has good outcomes in 70โ90% of cases at 5 years depending on the underlying indication. Rejection is the main risk and is treatable if detected early.
What is the difference between DALK and PKP for keratoconus?
DALK replaces only the outer layers, preserving the patient's own endothelium โ this means rejection risk is very low and graft survival is excellent. PKP replaces all layers, including the endothelium, which is immunologically active and more susceptible to rejection. For keratoconus with healthy endothelium, DALK is strongly preferred at Sentra Clinic.
Where does the donor tissue come from?
Donor corneas are sourced from NOTTO (National Organ and Tissue Transplantation Organisation)-affiliated eye banks in India, which certify the tissue for safety and optical quality. We do not use internationally sourced tissue; all donor tissue is ethically sourced within India's regulatory framework.
How long is recovery after corneal transplant surgery?
DSAEK: Vision often improves within 4โ8 weeks; best vision by 3โ6 months. DALK: Visual improvement over 6โ12 months, with suture removal and final visual refraction at 12โ18 months. PKP: Longest recovery โ best vision achieved at 18โ24 months after suture removal and stable refraction.
๐ฌ Corneal disease specialist in Malad East, Mumbai.
