اپولو ہسپتال، لکھنؤ میں قرنیہ کی پیوند کاری

Corneal transplantation is one of the oldest and most successful forms of human tissue transplantation. For patients in Uttar Pradesh living with corneal scarring, keratoconus or corneal decompensation, the procedure can restore useful sight, though outcomes vary from person to person and no result can be guaranteed. This page explains how corneal transplant surgery is planned and performed at Apollo Hospitals Lucknow, what recovery realistically involves, and how to prepare if you are travelling in from a nearby district.

Why Patients Choose Apollo Hospitals Lucknow for Corneal Transplant

• Part of the Apollo Hospitals group, established in 1983 ? India's first large corporate hospital network, with more than four decades of clinical experience and over 70 hospitals across the country. Apollo Hospitals Lucknow serves as a tertiary referral centre for Uttar Pradesh, Bihar and neighbouring states.
• A dedicated Ophthalmology department with consultant ophthalmologists and cornea-trained surgeons, supported by anaesthesiology, radiology and internal medicine teams under one roof ? important because many corneal patients also have diabetes, hypertension or autoimmune disease that affects healing.
• Combined consultant experience running into several decades across cornea, cataract, glaucoma and retina services. The exact size of the current cornea team and each surgeon's individual experience can be confirmed with the OPD desk when you book, as the panel changes over time.
• Modern operating microscopes and microsurgical instrumentation supporting both full-thickness (penetrating) and modern lamellar techniques such as DSEK, DMEK and DALK, where the case is suitable. Technique selection depends on which corneal layers are diseased, not on preference alone.
• Full diagnostic work-up in-house ? corneal topography and tomography, specular microscopy for endothelial cell counts, anterior segment imaging, biometry and B-scan ultrasound where the cornea is too opaque to see through.
• Structured donor tissue pathway ? corneal grafts in India are sourced only through licensed eye banks operating under the Transplantation of Human Organs and Tissues Act. Apollo Hospitals Lucknow coordinates with recognised eye banks; because tissue availability depends on donation, a waiting period is normal and cannot be fixed in advance.
• Care pathways for all ages ? including paediatric corneal opacity and congenital conditions (managed with paediatric anaesthesia support and closer amblyopia follow-up), working-age adults needing early visual rehabilitation, and elderly patients with Fuchs' dystrophy or post-cataract corneal decompensation who need cardiac and diabetic clearance before surgery.
• Rehabilitation beyond the graft ? post-transplant spectacle and contact lens fitting, rigid gas-permeable and scleral lens options for irregular astigmatism, and occupational guidance for people returning to farming, driving, teaching, tailoring or screen-based work.
• سائٹ پر انشورنس اور TPA ڈیسک to help with pre-authorisation, cashless approval and documentation for government and private schemes.
• 24x7 emergency and inpatient support, which matters for graft rejection, raised eye pressure or suture-related problems that need same-day review.

جائزہ

Corneal transplant, also known as keratoplasty, is a vital surgical procedure that involves replacing a damaged or diseased cornea with a healthy donor cornea. At Apollo Hospitals Lucknow, the eye care team uses current technology and established surgical techniques with the aim of achieving the best possible outcome for each patient. The ophthalmology team is committed to individualised care and to clear, honest counselling about what a graft can and cannot achieve. The focus is on restoring functional vision and improving quality of life for people who genuinely need this procedure, while being transparent that visual recovery after keratoplasty is gradual and variable.

کارنیل ٹرانسپلانٹ کیوں ضروری ہے؟

Corneal transplants are often necessary for individuals suffering from various corneal diseases, such as keratoconus, corneal scarring, or corneal dystrophies. These conditions can lead to significant vision impairment, affecting daily activities and overall quality of life. The cornea is the eye's outermost transparent layer, and its clarity and regular shape are crucial for proper vision. When the cornea becomes cloudy, thinned or distorted, light cannot enter and focus in the eye effectively, resulting in blurred, glare-affected or diminished vision.

The potential benefits of a corneal transplant are substantial. By replacing the diseased cornea with healthy donor tissue, many patients experience improved vision, reduced discomfort and a return to normal activities. At Apollo Hospitals Lucknow, the team recognises the importance of timely intervention and the meaningful impact a successful corneal transplant can have ? while also being clear that some eyes with long-standing damage to the retina or optic nerve may see limited improvement even with a perfectly clear graft.

Common indications seen in this region

• Corneal scarring after infection ? bacterial, fungal or viral keratitis. Fungal keratitis is particularly common in agricultural districts of Uttar Pradesh, often following injury with vegetative matter during harvesting or threshing.
• کیراٹونکس ? progressive thinning and cone-shaped bulging, typically starting in the teens or twenties, frequently linked to chronic eye rubbing and allergic eye disease.
• Post-traumatic scarring ? road traffic injury, firecracker injury, lime or chemical burns, and industrial or workshop injuries.
• بلوس کیراٹوپیتھی ? corneal swelling and painful blistering after complicated cataract surgery or long-standing endothelial failure.
• فوکس کی اینڈوتھیلیل ڈسٹروفی and other inherited dystrophies.
• Corneal thinning, melting or perforation needing urgent tectonic grafting to preserve the structure of the eye.
• گرافٹ کی ناکامی requiring a repeat (regraft) procedure.

تاخیر کے خطرات

Delaying a corneal transplant when it is clearly indicated can lead to serious complications. As corneal disease progresses, it can cause irreversible damage to the eye, leading to further vision loss or, in severe cases, blindness. Prolonged corneal scarring or disease can also result in increased discomfort and a higher risk of developing secondary eye conditions such as glaucoma or cataract.

Timely assessment is important. At Apollo Hospitals Lucknow, the team encourages patients to seek consultation as soon as they notice symptoms of corneal disease rather than waiting for vision to deteriorate further. Additional consequences of long delay include:

• New blood vessel growth into the cornea (vascularisation), which measurably increases the risk of graft rejection later. A graft placed into a deeply vascularised, scarred cornea has a poorer prognosis than one placed into a clear, avascular bed.
• Loss of the option of a simpler operation. Early keratoconus may be managed with collagen cross-linking, contact lenses or intrastromal ring segments. Once the cornea scars or hydrops occurs, transplant may become the only option.
• Amblyopia in children. A child with a dense central corneal opacity that is not treated within the visual development window may not regain good vision even after a successful graft.
• Perforation risk in progressive thinning or untreated infection, converting a planned operation into an emergency one with a poorer outcome.
• Chronic pain and dependence on others in bilateral disease, with loss of earning capacity and driving eligibility.

Delay is not always harmful, however. In some stable conditions the correct advice is careful observation, and rushing into a graft is not in the patient's interest. Your surgeon will explain which category your eye falls into.

کارنیل ٹرانسپلانٹ کے فوائد

Undergoing a corneal transplant can offer a number of benefits, including:

• بصارت بحال: Many patients experience significant improvement in vision, allowing them to return to daily activities and enjoy a better quality of life.
• تکلیف میں کمی: Patients often report a decrease in eye pain and discomfort following the procedure, as healthy donor tissue relieves the swelling and blistering associated with corneal disease.
• بہتر جمالیاتی ظاہری شکل: A clear cornea improves the overall appearance of the eye, which can contribute to improved self-esteem and confidence ? an important consideration for young patients and for those facing marriage or employment interviews.
• دیرپا نتائج: With advances in surgical technique and post-operative care, many patients enjoy long-term graft survival and stable vision. Grafts are not permanent in every case, and some patients need a repeat procedure years later.
• ذاتی نگہداشت: At Apollo Hospitals Lucknow, treatment plans are tailored to each patient's diagnosis, age, occupation and general health, with the aim of achieving the best realistic outcome.

تیاری اور بحالی

قرنیہ ٹرانسپلانٹ کی تیاری میں کئی اہم مراحل شامل ہیں:

1. مشاورت: Book a comprehensive eye examination with the specialists at Apollo Hospitals Lucknow. This determines whether the procedure is needed and assesses your overall eye health.
2. آپریشن سے پہلے کی ہدایات: Follow the guidance given by your surgeon, which may include stopping or changing certain medicines or eye drops.
3. نقل و حمل کا بندوبست کریں: Because the procedure is performed under anaesthesia, someone should accompany you to and from the hospital.
4. آپریشن کے بعد کی دیکھ بھال: After surgery, follow your surgeon's instructions closely, including the use of prescribed eye drops and attendance at every follow-up appointment.

Recovery from a corneal transplant varies from patient to patient, but these general principles apply:

• باقی: Allow your eyes to rest and avoid strenuous activity for the first few weeks after surgery.
• آنکھیں رگڑنے سے گریز کریں: Protect the eye from any trauma or irritation. Eye rubbing is one of the commonest avoidable causes of graft damage.
• فالو اپ اپائنٹمنٹس میں شرکت کریں: Regular review is essential for monitoring healing and detecting rejection early.
• کسی بھی تشویش کی اطلاع دیں: If you develop unusual symptoms such as increasing pain, redness or reduced vision, contact your treating team immediately.

Apollo Hospitals Lucknow provides support through the recovery period, including help with drop schedules and suture-related reviews.

موجودہ طبی رہنمائی اور کیا تبدیلی آئی ہے۔

Practice in India is guided principally by the آل انڈیا آپتھلمولوجیکل سوسائٹی (AIOS) اور اس کی کارنیا سوسائٹی آف انڈیاساتھ ساتھ نابینا پن اور بصری خرابی کے کنٹرول کے لیے قومی پروگرام (NPCBVI) under the Ministry of Health and Family Welfare, and the internationally used American Academy of Ophthalmology Preferred Practice Pattern for Corneal Ectasia and Corneal Edema/Opacification (2024 update). The following points reflect current mainstream practice rather than one single document:

• Lamellar surgery is preferred where the disease allows it. When only the inner endothelial layer has failed (Fuchs' dystrophy, bullous keratopathy), endothelial keratoplasty ? DSEK/DSAEK or DMEK ? is now favoured over full-thickness penetrating keratoplasty because visual recovery is faster and the risk of rejection is lower. When the endothelium is healthy but the front layers are scarred (many keratoconus and post-infection scars), deep anterior lamellar keratoplasty (DALK) preserves the patient's own endothelium.
• Penetrating keratoplasty (PK) remains essential for full-thickness scars, perforations, failed grafts and complex paediatric cases. It has not been replaced; it has been reserved for the cases that need it.
• Corneal collagen cross-linking has changed keratoconus management. Because cross-linking can halt progression in early and moderate disease, the proportion of young Indian patients ultimately needing a graft has fallen. Early referral is therefore more valuable than ever. Accelerated and trans-epithelial protocols are now widely used in Indian centres.
• Eye banking standards. Donor tissue must come through a licensed eye bank under the Transplantation of Human Organs and Tissues Act, 1994 (amended 2011 and Rules 2014). Hospital Cornea Retrieval Programmes have improved tissue supply in Indian cities, but availability still fluctuates.
• Topical steroids remain the backbone of rejection prevention, usually tapered over many months to years. Long-term steroid use requires monitoring for raised intraocular pressure and cataract ? one reason lifelong follow-up is advised.
• Systemic immunosuppression is not routine for most corneal grafts, unlike solid-organ transplant. It is considered selectively in high-risk eyes, repeat grafts and severe surface disease.
• Keratoprosthesis (artificial cornea) is reserved for eyes that have already failed multiple grafts or have severe ocular surface disease, and is offered only in selected specialist centres.

Guidelines are updated periodically. What applies to your eye should be confirmed with your treating surgeon rather than assumed from any web page, including this one.

سرجری کا وقت اور طریقہ کار سے پہلے کا مرحلہ

Corneal transplant is usually a planned procedure, with two important exceptions: perforated corneas and infections not responding to medication, which may need urgent or emergency grafting to save the eye.

Typical planned pathway

1. First consultation and detailed examination ? vision testing, slit-lamp examination, corneal topography or tomography, specular microscopy, intraocular pressure and dilated retinal assessment where the view allows.
2. Retinal and optic nerve viability check ? if the cornea is opaque, B-scan ultrasound and light projection testing help estimate how much vision a graft could realistically restore.
3. Treating the surface first ? dry eye, allergic conjunctivitis, blepharitis, lid malposition, trichiasis and any active infection are settled before a graft, because an unhealthy surface is the commonest reason grafts fail.
4. Fitness for anaesthesia ? blood tests, blood sugar and HbA1c, ECG, and physician or cardiology clearance for older patients or those with diabetes, hypertension or heart disease. Blood thinners are reviewed with the prescribing doctor; they are not stopped without advice.
5. مشاورت اور رضامندی۔ ? technique, realistic visual expectation, rejection risk, drop discipline, follow-up burden and cost estimate.
6. انشورنس سے پہلے کی اجازت ? submitted through the hospital insurance desk once the surgery is planned.
7. Eye bank listing and tissue allocation ? your name is registered and surgery is scheduled when suitable tissue of adequate quality becomes available. This waiting time cannot be promised in advance and is often the reason a date shifts.

Days before surgery

• Antibiotic drops may be started a day or two beforehand.
• Stop eye rubbing completely ? this is critical in keratoconus.
• Fast as instructed, generally six to eight hours before general anaesthesia, less for local anaesthesia.
• Remove kajal, surma, mehendi on the hands is fine, but avoid facial cosmetics and hair oil around the temples on the day of surgery.
• Bathe and wash your hair the night before or that morning, since head washing will be restricted afterwards.
• Trim nails short ? this reduces harm from unconscious eye rubbing during sleep.

تکنیک کے اختیارات کا موازنہ

The surgeon selects the technique based on which layers of your cornea are diseased. The table below is for general understanding only.

Non-surgical and pre-graft alternatives worth discussing

• Rigid gas-permeable, hybrid or scleral contact lenses ? can give good vision in keratoconus and irregular corneas without any surgery.
• Corneal collagen cross-linking ? to stop keratoconus progressing, not to improve vision.
• Intrastromal corneal ring segments ? to reshape a keratoconic cornea in selected cases.
• Phototherapeutic keratectomy ? for superficial scars and irregularities.
• Medical management of corneal oedema ? hypertonic saline drops and pressure control, useful for symptom relief or while waiting.
• Amniotic membrane grafting, tarsorrhaphy or glue with bandage lens ? to stabilise a threatened cornea before definitive surgery.

طریقہ کار بعض اوقات ایک ہی نشست میں انجام دیا جاتا ہے۔

Several conditions may be addressed together to avoid repeated surgery and repeated anaesthesia:

• Triple procedure ? keratoplasty with cataract removal and intraocular lens implantation, common in older patients.
• Secondary IOL implantation or IOL exchange in eyes with a displaced or unsuitable lens.
• Anterior vitrectomy and synechiolysis to clear the front of the eye and free iris adhesions.
• Glaucoma surgery or drainage device when eye pressure is uncontrolled ? pressure control protects the graft.
• Pupilloplasty or iris repair after trauma, which also reduces glare.
• Lid and lash correction ? entropion, ectropion or trichiasis repair, so lashes do not rub the new graft.
• Punctal occlusion or limbal stem cell procedures to improve a dry or damaged ocular surface.

Combining procedures can lengthen surgery and slow visual recovery slightly, so the decision is individualised.

فیز فیز ریکوری ٹائم لائن

Timelines below are typical for penetrating or lamellar keratoplasty and will be adjusted for your technique and healing.

معمول کی سرگرمی، کام اور کھیل کی طرف لوٹنا

These are general guides. Your surgeon's advice for your eye takes priority.

Protecting the Graft and Preventing Recurrence

• Never rub the eye. Treat itching with prescribed anti-allergy drops instead. In children, cut nails short and use night shields.
• Take steroid drops exactly as prescribed and taper only on advice. Stopping early is a leading cause of rejection; continuing too long can raise eye pressure. Both need supervision.
• Control allergic eye disease ? dust, pollen, smoke and pet dander drive the rubbing that damages grafts.
• Manage the ocular surface ? lubricants for dry eye, lid hygiene with warm compresses, and treatment of any lash malposition.
• حفاظتی چشمہ پہنیں۔ during farm work, welding, grinding, carpentry and sport, and while riding.
• Control diabetes, blood pressure and any autoimmune disease. Poor glycaemic control slows epithelial healing.
• Treat recurrent herpes simplex keratitis with long-term oral antiviral prophylaxis if advised ? the original disease can recur in the new graft.
• Attend follow-up for life. Rejection is usually treatable if caught within days, and often not reversible if ignored for weeks.
• Do not stop follow-up because vision is good. Endothelial cell loss and late rejection are silent in the early stages.

بچوں اور بوڑھے بالغوں کے لیے تحفظات

بچوں اور نوجوانوں

• Paediatric keratoplasty is technically harder ? the eye is softer, the tissue more elastic, and inflammation more vigorous, so rejection rates are higher and follow-up more intensive.
•  
• Amblyopia therapy ? patching, glasses and contact lens correction ? is as important as the surgery itself. A clear graft without visual rehabilitation may still leave poor vision.
• Sutures loosen faster in children and need earlier removal.
• Adolescent keratoconus is frequently linked to allergic eye rubbing; controlling allergy and stopping rubbing protects both the graft and the other eye.
• School, exam schedules and hostel drop administration should be planned with the team in advance.

پرانے بالغ

• Bullous keratopathy and Fuchs' dystrophy predominate; endothelial keratoplasty is often the preferred option, with faster recovery.
• Cardiac, renal, diabetes and anticoagulant issues need physician clearance. Many procedures can be done under local anaesthesia, avoiding general anaesthesia risk.
• Arthritis, tremor or poor dexterity make self-instillation of drops difficult ? a trained family member should take responsibility, and drop charts help.
• Face-up posturing after DSEK or DMEK can be uncomfortable with cervical spondylosis or breathlessness; tell the team beforehand so an alternative plan can be discussed.
• Fall prevention matters ? remove loose rugs, improve lighting on stairs, keep a night light near an Indian-style toilet, and use a raised commode.
• Coexisting glaucoma, macular degeneration or diabetic retinopathy limit how much vision a graft can restore; this should be discussed openly before consenting.

If You Choose Not to Have the Transplant

Declining or deferring surgery is a legitimate choice, particularly if the other eye sees well or general health is poor. What follows depends on your diagnosis:

• Stable central scar: vision remains poor but the eye is comfortable and safe. Many people manage well using the better eye, with protective glasses to safeguard it.
• Keratoconus without a graft: vision may still be workable with rigid or scleral lenses. Cross-linking can be considered if progression continues.
• Bullous keratopathy: pain, glare and blistering usually worsen. Hypertonic saline, bandage lenses, pressure control and, in painful blind eyes, amniotic membrane or a conjunctival flap can give comfort without transplant.
• Progressive thinning or active infection: declining surgery risks perforation, endophthalmitis and loss of the eye. This is the situation where deferral carries the greatest danger.
• Low-vision rehabilitation ? magnifiers, high-contrast reading material, screen accessibility settings, orientation training and certification for disability benefits ? is available and worthwhile whether or not you have surgery.

Ask your surgeon to record the specific risk in your case so the decision is informed rather than assumed.

What Influences the Cost of a Corneal Transplant

Cost varies considerably between patients. Apollo Hospitals Lucknow provides a written estimate after assessment. For current figures, please speak to the hospital reception or the billing and insurance desk ? no amounts are quoted here, and figures published on price comparison websites are not reliable.