Corneal Transplant in Ranchi — Keratoplasty Surgery
Corneal transplant surgery (full-thickness and lamellar keratoplasty) for corneal blindness, keratoconus, and corneal scarring — performed by Dr. Dibya Prabha, MS Ophthalmology, at Neurovision Clinic, Ranchi.
What is Corneal Transplant (Keratoplasty)?
Corneal transplant, or keratoplasty, is a microsurgical procedure in which damaged or diseased corneal tissue is removed and replaced with healthy donor corneal tissue obtained through eye donation. The cornea is the transparent front window of the eye — when it becomes scarred, irregular, or opaque from disease or injury, vision is severely impaired. Corneal transplant types include: penetrating keratoplasty (PK — full-thickness replacement of all five corneal layers), deep anterior lamellar keratoplasty (DALK — replacement of the front layers while preserving the patient's own healthy endothelial layer, reducing rejection risk), and Descemet stripping endothelial keratoplasty (DSEK/DMEK — selective replacement of only the innermost endothelial layer through a small incision, with faster recovery).
At Neurovision Clinic in Ranchi, Dr. Dibya Prabha evaluates each patient with corneal topography, pachymetry, slit-lamp examination, and endothelial cell analysis to determine which procedure offers the best balance of visual outcome and safety. The clinic coordinates with eye banks for timely access to high-quality donor corneal tissue.
Corneal transplant is one of the most successful forms of human tissue transplantation, with graft survival rates exceeding 90% in the first year for low-risk cases.
Why is Corneal Transplant (Keratoplasty) Done?
- •To restore vision lost due to corneal opacity or scarring from infections (bacterial, fungal, or viral keratitis — particularly herpes simplex and herpes zoster), trauma, or chemical burns
- •To treat advanced keratoconus when contact lenses and corneal cross-linking can no longer provide adequate vision — DALK is the preferred procedure as it preserves the patient's own endothelial cells
- •To replace a failing endothelial pump in Fuchs endothelial dystrophy, pseudophakic bullous keratopathy, or post-surgical corneal edema — treated with DSEK or DMEK for faster visual recovery compared to full-thickness PK
- •To repair or remove corneal scars, pterygium recurrences, or dermoid tumors affecting the visual axis
- •To treat corneal perforations or severe thinning (descemetocele) that threaten the structural integrity of the eye — emergency tectonic keratoplasty
- •To improve vision and ocular comfort when the cornea is irregular, scarred, and unsuitable for spectacles or contact lens correction alone
How Corneal Transplant (Keratoplasty) is Performed
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Pre-operative Assessment and Donor Matching
Dr. Dibya Prabha performs a thorough evaluation including corneal topography, pachymetry, anterior segment OCT, endothelial cell count (specular microscopy), and detailed slit-lamp examination. The surgical plan — PK, DALK, or DSEK/DMEK — is chosen. The eye bank is contacted to arrange donor corneal tissue. Donor corneas are rigorously screened for infectious diseases (HIV, hepatitis B and C, syphilis) and the endothelial cell count is verified to ensure high-quality tissue.
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Anaesthesia and Eye Preparation
The procedure is performed under local anaesthesia (peribulbar block) with sedation, or general anaesthesia in select cases. The eye and surrounding skin are cleaned with povidone-iodine, and a sterile surgical drape is applied. The pupil is constricted with miotic drops to protect the lens during surgery.
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Recipient Corneal Trephination
A circular blade (trephine) of precisely measured diameter is used to cut the recipient's diseased cornea. In PK, the full thickness is cut and the central corneal button is removed. In DALK, only the anterior layers are dissected and removed, leaving the healthy Descemet membrane and endothelium intact.
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Donor Corneal Suturing
The donor corneal button (prepared to the exact same diameter) is placed into the recipient bed and secured with multiple micro-sutures (typically 16 interrupted or a combination of interrupted and running sutures using 10-0 nylon). In DSEK/DMEK, the donor endothelial graft is inserted through a small incision and positioned against the recipient's stroma with an air bubble — sutures are minimal or absent.
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Post-operative Care and Suture Management
At the end of surgery, antibiotic and steroid injections are given. The eye is patched and shielded. You are monitored in recovery and discharged with a detailed medication and follow-up schedule. The first 24–48 hours are critical — Dr. Prabha sees you the next day. Sutures remain in place for months (often 12–18 months for PK/DALK), during which vision fluctuates. Suture removal is a gradual process performed in the clinic over several visits once healing is satisfactory.
How to Prepare
- •Undergo a complete pre-operative evaluation including corneal imaging, endothelial cell count, and medical clearance. Dr. Prabha will determine which keratoplasty technique is best suited to your specific condition.
- •Do not eat or drink anything for at least 6–8 hours before the procedure if sedation or general anaesthesia is planned.
- •Discuss all medications with Dr. Prabha, particularly blood thinners and diabetes medications. Continue only those medications approved for the day of surgery.
- •Arrange for someone to accompany you home after surgery — your eye will be patched and your vision will be poor in the operated eye for weeks to months.
- •Understand that corneal transplant is monitored long-term — schedule flexibility for frequent follow-ups in the first year (day 1, week 1, month 1, month 2, month 3, month 6, and then periodically for suture removal and refraction).
- •Be aware of the signs of graft rejection — sudden redness, pain, decreased vision, or increased light sensitivity — and the importance of reporting these to Dr. Prabha immediately, as early treatment can often reverse rejection.
Related Conditions
Corneal Transplant (Keratoplasty) helps diagnose and monitor these conditions. Explore our condition pages for more detailed information about each.
Frequently Asked Questions
Where does the donor cornea come from?
Donor corneas are obtained through voluntary eye donation after death. In India, eye banks coordinate the collection, screening, and distribution of donor corneas through a national network. The donor cornea is rigorously tested for infectious diseases (HIV, hepatitis B and C, syphilis), and the endothelial cell density is measured to ensure high-quality tissue. The donor's identity remains anonymous. At Neurovision Clinic, Ranchi, Dr. Dibya Prabha works with accredited eye banks to procure tissue. Eye donation pledges are encouraged — anyone can pledge their eyes, and corneas can be donated within 6 hours of death regardless of age, spectacles use, or most systemic illnesses. Family consent is essential at the time of death.
How long does corneal transplant recovery take?
Visual recovery after corneal transplant is slow and deliberate. In DSEK/DMEK, significant visual improvement may be seen within 4–8 weeks. With PK and DALK, sutures cause corneal surface irregularity, and stable vision may take 12–18 months as sutures are selectively removed and refraction stabilizes. Rigid gas permeable contact lenses are sometimes fitted after all sutures are out to achieve best-corrected vision. Dr. Dibya Prabha provides a realistic timeline during your consultation — corneal transplant is a journey that rewards patience with steadily improving vision.
What is the risk of corneal graft rejection?
Graft rejection occurs when the recipient's immune system recognizes the donor cornea as foreign and attacks it. In low-risk PK, the rejection rate is approximately 10–20% over 5 years. DALK has a lower rejection risk because the endothelium — the layer most vulnerable to immune attack — is preserved from the patient. DSEK/DMEK rejection rates are also lower (under 10%). Most rejection episodes can be reversed if caught early with intensive topical steroids. Patients remain on a low-dose maintenance steroid drop indefinitely. Dr. Dibya Prabha teaches every patient the warning signs of rejection and the importance of immediate reporting.
What is the cost of corneal transplant surgery in Ranchi?
The cost of corneal transplant at Neurovision Clinic, Ranchi depends on the type of procedure (PK, DALK, DSEK/DMEK), the eye bank processing fees for donor tissue, and the operating theatre charges. Dr. Dibya Prabha provides a transparent cost estimate during the pre-operative consultation. The clinic is committed to providing affordable corneal surgery for patients across Ranchi, Jharkhand, and neighboring states, including Bihar, Odisha, and West Bengal.