Hyderabad, India, December 10, 2008 --(PR.com
)-- Corneal replacement surgery has witnessed a recent shift from conventional full thickness transplantation procedures (penetrating keratoplasty), to lamellar corneal surgery to selectively replace dysfunctional layers. Anterior lamellar corneal surgical procedures, help retain the healthy host endothelium and thereby prevent endothelial rejection. This has tremendous benefit to young patients suffering from keratoconus, various corneal stromal dystrophies, and corneal scars sparing the endothelium. In fact full thickness penetrating keratoplasty is no longer the first choice of treatment of corneal replacement surgery in such cases. Anterior lamellar procedures include manual techniques such as anterior lamellar keratoplasty, maximum depth anterior lamellar keratoplasty, deep lamellar anterior keratoplasty with baring of the Descemet’s membrane (big bubble technique), and automated lamellar therapeutic keratoplasty.
Posterior lamellar keratoplasty procedures are aimed at replacing the dysfunctional endothelium with healthy tissue. Endothelial Keratoplasty (EK) has various terms including Deep Lamellar Endothelial Keratopalsty (DLEK), Descemet’s stripping endothelial keratoplasty (DSEK), and Descemet’s stripping automated endothelial keratoplasty (DSAEK). Commonly performed for Fuch’s endothelial dystrophy, Bullous keratopathy, and other endothelial disorders. Absence of surface incisions or sutures maintain smooth surface topography, resulting in faster visual recovery compared to conventional penetrating keratoplasty. A smaller peripheral incision in EK also provides greater tectonic stability.
Due to these advantages lamellar corneal surgical procedures have become more popular and corneal surgeons worldwide are attempting to incorporate them into their surgical practice. However, there are several surgical techniques evolved by different surgeons after years of practice, and each has its own learning curve. Most surgeons are unable to initiate into lamellar corneal surgery due to lack of proper training facility. Various instruction courses at international meetings are not sufficient enough to provide essential information required for initiation into lamellar corneal surgery.
Complications in the initial cases also acts as stumbling blocks for surgeons who try to attempt these procedures without proper training.
Few centers in the world, located at Portland, Netherlands, Singapore provide short courses on lamellar corneal surgery, either the anterior procedures, or the posterior procedures. However no such courses were available in India.
Dr Rajesh Fogla, senior consultant, corneal surgeon at Apollo Hospitals, Hyderabad, India has been performing lamellar corneal surgeries since 1997. He started with anterior lamellar corneal surgeries after training in UK with Dr Chad Rostron, at St Georges Hospital, London, UK. He was the first person in India to perform Deep Lamellar Endothelial Keratoplasty, back in 2004 after training with Dr Mark Terry , in Portland, USA. He also organized a major meeting on Lamellar Corneal Surgery in Chennai, India in 2004, attended both by Dr Mark Terry, and Dr Mohammed Anwar. Since then Dr Fogla has participated in various international and national meetings, propagating the advantages of lamellar corneal surgery. He has performed live surgery on numerous occasions both at various national and international meetings. He also participates as an instructor at various wet lab sessions at various international meetings.
With the desire to train more corneal surgeons in India, Dr Fogla initiated training course on lamellar corneal surgery for the first time in India. This 3 day course, covers both anterior and posterior lamellar corneal procedures. Candidates are able to closely interact to understand the basic steps of these procedures and how to successfully perform them with ease. Live surgery also gives them a first hand experience in the operation theater on lamellar corneal surgery. They are able to watch numerous unedited lamellar corneal surgical procedures, including complications and its management. Each candidate gets the opportunity to practice extensively in the wet lab on donor eyes. Feedback from the candidates attending the first and second course has been extremely positive. This course is open both to national and international candidates with interest in corneal surgery.
The next course is scheduled from 6th to 8th of March 2009. Interested candidates can write to Dr Rajesh Fogla at email@example.com or firstname.lastname@example.org