Chennai :

When UK-based surgeon Harminder Dua discovered a new layer in the cornea in September this year, it was considered an achievement. But the real buzz was when Chennai doctors took the breakthrough to a new level and performed a procedure in which a one-year-old girl gave sight to 64-year-old M Shanmugam, a retired air conditioner mechanic from Avadi.

The exciting procedure, which according to Dr Amar Agarwal of Agarwal Eye Hospital that performed the procedure is the first of its kind in the world, is expected to “revolutionize” the way eye transplants are done.

In the new technique, Pre-Descemet Endothelial Keratoplasty (PDEK), the donor can be of any age. In the earlier procedures, the donor had to be above 50 years of age.

Conventionally, doctors were using a whole cornea or parts of the five layers of the cornea to perform correction surgeries. A couple of months ago, Dr Harminder Dua discovered a sixth layer between the stroma and the descemet membrane which is now named Dua’s layer. In the PDEK technique, doctors take the innermost two layers of the cornea, along with Dua’s layer and graft it in the patient’s eye. “The biggest advantage of this technique is that age is not a bar to be a donor. Moreover, as Dua’s layer is slightly more fibrous, it becomes easier to manipulate the tissue,” said Dr Amar Agarwal.

In PDEK, the donor’s cornea is kept upside down and injected an air bubble to separate the layers. “After procuring the tissue, we make a minute incision in the patient’s eye and fix it. Once the graft is unrolled, the transplant is complete and vision is restored,” said the doctor. The entire procedure can be wrapped up in 25 minutes after which the patient is advised to rest and can leave the following day. “Another major advantage of PDEK is that there is negligible graft rejection and no sutures are involved as only a small tissue is used for the transplant. Preliminary studies show that the graft thickness is about 28 to 30 microns and it behaves well,” said Dr Agarwal. “We have performed 16 such procedures since September but this surgery gains significance as the donor is a one-year-old,” added the doctor.

source: http://www.articles.timesofindia.indiatimes.com / The Times of India / Home> City> Chennai> Cornea / TNN / November 10th, 2013