Corneal transplants are performed for many reasons, and in Dr. Motwani’s opinion, they are performed in many situations where better solutions or treatments are available. Still, many patients have received corneal transplants and the visual problems that come with them.
Corneal transplants create significant new problems for patients. In traditional transplants, a donor cornea from a cadaver must be used, which does not necessarily match in shape to the recipient. Surgeons sew the cornea into the recipient, and virtually all patients will have some irregular astigmatism, limiting vision and visual quality. This procedure can lead to ghosting, multiple images, significant to extreme glare, streaking, and halos, and limitation of overall vision. Simply reading a line on an eye chart does not mean the vision is ultimately improved. Many corneal transplants will improve the ability to read on a Snellen eye chart but show compromised quality.
It has become possible with topographic guided ablation utilizing the patented CREATE Protocol (Corneal Repair Epithelium and Topography Enhanced) to improve the irregular shape of a cornea transplant dramatically. This procedure uses the patented LYRA and San Diego Protocols and the reduced irregularity masked by the epithelium (which normal topographic guided analysis cannot detect), which Dr. Motwani has also patented, to create a virtually uniform cornea. This protocol can dramatically decrease visual symptoms such as ghosting, double and triple images, glare, halos, and other visual symptoms. It can also, in many cases, increase the quantity of vision as less light gets scattered.
With advancements in partial corneal transplants, such as transplanting only the corneal endothelium, it may be possible to keep the newly reshaped anterior cornea long-term or even permanently transplant only the endothelium.
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