DLEK

Endothelial Keratoplasty (DSEK/ DSAEK/ DMEK) ie Endothelial transplantation surgery

EK refers to a new method of advanced corneal surgery(DSEK/DSAEK/DMEK)
wherein the unhealthy endothelial layer of the cornea is selectively replaced with
healthy donor tissue, without the need for surface incisions or sutures. This results in
better refractive outcome compared to conventional corneal grafts. Moreover there is
no risk of suture related complications such as infections, vascularisation etc.
Tectonically the cornea is much stronger following EK as compared to conventional
full thickness corneal grafts.

Conventional corneal grafting procedure requires full thickness excision of the host cornea, followed by replacement of
corneal tissue from donor cornea. This corneal tissue needs to be secured in position with multiple sutures.

Dehiscence of the graft host
junction following trauma

Conventional full thickness
corneal transplantation surgery

Corneal infection resulting from
loose or broken sutures

DLEK Surgical steps
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Endothelial Keratoplasty (DSEK) ie Endothelial transplantation surgery

Patients who have
undergone DLEK / DSEK
procedure to restore
corneal clarity and function

Corneal clarity restored with DSEK surgery

Hazy cornea due to endothelial damage

Sister Michaelina (Chennai)
DSEK done in left eye,
now enjoys 6/12 (20/40)
unaided vision

Mr Rajat Kanti Mukherjee, 66 year old gentleman had Fuch's endothelial dystrophy, a condition
wherein the inner layer of the cornea stops functioning. Due to this the cornea becomes water-logged
and loses its clarity. He also had cataracts in both eyes.

His vision progressively got worse with time, and he decided to get operated. The left eye underwent a
conventional full thickness graft, with cataract surgery and intraocular lens implantation. He was not
happy with the procedure, as his unaided vision was still poor after the surgery. With thick glasses the
vision improved, but he found it difficult to wear them for long hours.

After a duration of 10 months, his vision again got worse, and his doctor informed him that
his graft had failed, and would need another surgery to restore its clarity.

Mr Mukherjee, was very scared to go in for another surgery.....

Note the hazy cornea due to failed graft in the left eye.

Shyamala (Kolkata)
DLEK done in right eye,
now enjoys 6/6 (20/20)
unaided vision

As the vision in his right eye also got worse with time, Mr Mukherjee decided to undergo
phacoemulsification with foldable intraocular lens implantation and DSEK procedure in the
right eye.

He was extremely pleased with the outcome of surgery, as his unaided vision was quite good.
6/12 (20/40) at 5 weeks post surgery. He had never experienced similar outcome following
prior surgery in his left eye. His best corrected visual acuity was noted to be 6/9 (20/30) with
glasses.
Note - absence of stitches on the corneal surface, clear cornea.

Suryanath (Jamshedpur)
DSEK done in left eye,
now enjoys 6/12 (20/40)
unaided vision

N.Ramanathan IRS(Retd) leela.ramanathan@gmail.com

I am 77 years old. I lost vision of my left eye in 1996 and that of my right eye in 2005- both after cataract surgery with IOL
implant.
On a visit to India last winter,almost blind, I had the good fortune to get introduced to Dr. Rajesh Fogla who performed the
DSEK surgery and removed the IOL implant in the right eye. Miraculously my vision was restored the very next day. The
surgery involved no corneal cutting, sutures or bandages and no pain at all ! By God's Grace there were no post surgical
complications.
Within a month of this major surgery I could return to the US. My local doctor here at New Jersey expressed that such a highly
specialised operation could be done with so much perfection in such a short notice in India ! This technique is still not in vogue
in the US, the prohibitive cost apart !
With vision of one eye restored, I am able to indulge in the luxury of reading a lot, taking long walks every morning etc all by
myself. My family and I are grateful to Dr.Fogla whose skill has given me my "second sight" and a new meaning to my twilight
years.

For more information on this specialized corneal surgical procedure call us or send us an email to schedule an appointment

Dr Rajesh Fogla DNB, FRCS, MMed has been performing specialized lamellar corneal surgery since 1998. He was the first surgeon to introduce Deep lamellar
endothelial keratoplasty procedure (DLEK) in India. He has published several papers in international journals on lamellar corneal surgery, and has delivered
lectures on the same topic on numerous occasions both national and international symposiums. He has conducted instruction courses on lamellar corneal surgery
also at international and national symposiums.

Dr Fogla is available in the clinic on weekdays between 9am to 5pm, ( 6 - 8 pm with prior appointments only)

You can reach him on +91 9866076750 or dr_fogla@yahoo.com