Sural Nerve used to perform Corneal Nerve Transplant at Hiranandani Hospital

Vashi, Mumbai: Doctor’s at Hiranandani Hospital, Vashi – A Fortis Network Hospital re-treated a 60 year old woman with total opacification of a corneal transplant done previously. Due to the loss of corneal nerve sensations (Viral Neurotrophic Keratopathy), the patient’s cornea was unable to heal well and she also experienced a loss of vision. If the doctors repeated the corneal transplant, there would have been similar effects leading to vision failure in the cornea, if loss of sensations were not addressed properly. She was suffering from Herpes simplex virus (HSV) keratitis, a virus that spreads across the skin forming a thin moist lining around many parts of the body such as the nose, mouth, throat and genitals which lead to the loss of corneal sensations.

The patient was referred to Dr Harshavardhan Ghorpade, Cornea, Cataract and Refractive Surgeon and Dr Sunil Moreker, Orbit and Oculoplastic Specialist at Hiranandani Hospital Vashi – A Fortis Network Hospital by her doctor whom she had initially approached. The doctor’s with the aid of Plastic and Cosmetic Surgeon, Dr.Vinod Vij performed the corneal transplant followed by grafting of a sensory nerve taken out from her foot called the Sural nerve, anatomizing it and connecting it to the Cornea along with the sensory nerves of her forehead.

Speaking about the case, Dr. Sunil Morekar, Orbit and Oculoplastic Specialist, Hiranandani Hospital, Vashi – A Fortis Network Hospital, said, “A Corneal transplant is a surgical procedure where a damaged cornea is replaced by a donated cornea. We planned and took the risk of the corneal transplant alongside using a new technique called Nerve Grafting as there was a high risk of failure of the grafted cornea, if only the corneal transplant was to be performed. This particular procedure has only been performed at a few centers across the Western World”.

“Instead of repeating the first corneal transplant we performed the combined procedure to eradicate the risk of the patient losing her sight. We are ecstatic that it was a success and the results positive. We are proud to be the first to conduct the combined surgery in India as this is a landmark in providing superlative care and better hope for patients who lose their eyesight due to corneal denervating diseases like Herpes, acoustic neuroma and trauma. Due to the precise execution of the procedure, the patient is responding well with 70% improvement in vision within just 6-8 weeks”, said Dr. Harshavardhan Ghorpade, Cornea, Cataract and Refractive Surgeon, Hiranandani Hospital Vashi- A Fortis Network Hospital.

It was noted that the patient experienced an improved vision as shown on the chart from 2 lines the very next day of the surgery to 4 lines on the chart 5 days later. However, according to doctors, the patient will experience normal sensations in a few days. The cornea is expected to remain clear, without any recurrence of complications related to the sensory loss.