Sir Ganga Ram Hospital

Hello Everyone!

I am Dr. Ikeda Lal. I am a cornea, cataract and refractive surgery specialist at Delhi Eye Centre and sir Ganga Ram Hospital. So, today we will talk about keratoconus. Ye bimari kafi common hai lekin logon ko iska pta nhi chalta. Keratoconus means conical shape of cornea. It is the front layer of the eye and in Hindi kali putli. Iske kya symptoms hain. Patient ka prescription of glasses badhta hai. And glasses ke sath bhi unko clear nazar nhi aata. Ghost images and double image dikhta hai. Cylindrical power glasses ka badhta hai and fluctuation rehta hai. To keratoconus konse patient ko ho skta hai? Ye problem genetic bhi hai. 2nd chronic eye rubbers. Hume jor se aankh rub nhi krni chaiye. Eye rub krne ka cause allergy bhi ho skta hai. Ye bimari young patient ko jyada effect krti hai. Mostly teenagers me payi jati hai. How doctor will access? Doctor pehle powers dekhega jisse use early sign ka pta chal jata hai. Slit lamp examination ke through bhi doctor ko pta chal jata hai ki keratoconus ki bimari hai ya nhi. Early stage me is problem ko detect krne ke lia test hai corneal topography test.

Isme cornea ki shape and thickness measure ki jati hai. Another symptom is steepness and thinning of the cornea. Ye test treatment plan krne me bhi help krta hai. First and foremost step is to stop the progression of the disease. Agar ye problem badh rhi hai to hum collagen cross-linking treatment dete hain. UV light and riboflavin ke interaction se cornea ko strong kia jata hai. Uske baad healing ke lia eyes pe contact lens lgaya jata hai jisko 4-5 days me hum hta dete hain. Starting ke kuch din painful hote hain but iska success rate kafi acha hai. The 2nd aspect of the treatment is to improve the vision. Glasses ke through acha treatment dia jata hai. Iske lia routine check-up ki jrurat pdti hai dekhne ke lia ki bimari aage progress to nhi kar rhi hai.

Thode advance cases me vision glasses se acha nhi hota hai to contact lenses fit kia jate hain. Ise hard contact lenses or rigid gas permeable (RGP), ROSE K lenses bhi kehte hain. Ye cornea ke upar lgte hain or vision ko bhut acha krte hain. Lekin iske sath hi handling bhut achi honi chaiye. Next treatment me hai jhan intax ko laser se ankhon me fit kia jata hai. Is se patient ka vision improve hota hai. Next is correction and decrease in power with laser. Isme cornea ko reshape kia jata hai or unki cylindrical power ko bhi kam kia ja skta hai.

Agar in sab treatment me se koi treatment kam nhi krta hai to hume in patients ka corneal transplant krna pdta hai. Iske results bhut ache hain. Success rate is more than 90%. Suregry advance hai islia hume pura cornea replace krne ki jrurat nhi pdti hai. Hum cornea ki aage ki layer ko hi replace krte hain. Ise technical language me deep lamellar endothelial keratoplasty (DLEK) kehte hain. Isme rejection ke chances kam ho jate hain. Isme eye ball ki strength jyada rehti hai. Ye last stage ka treatment hai jo patient ko kafi fayedemand rehta hai. Agar apki jaan pehlchan me koi hai jise ye problem hai to unka corneal specialist se aaj hi test krayein or time pe bimari detect kr ke uska treatment krayein.

Thank You!

Hello Everyone!

I am Dr. Ikeda Lal. I am a cornea, cataract and refractive surgery specialist at Delhi Eye Centre and Sir Ganga Ram Hospital. Today we will talk about how to get freedom from glasses and contact lenses. Glasses are not only cosmetic concern but also affect our lifestyle. More for swimmers and sports people. And there are certain jobs which require to have perfect vision like army. So, how to correct refractive errors. Refractive is the term which we use to remove glasses. So, who is the ideal candidate for these procedures? The minimum age limit to undergo refractive surgery is 18 years. Our vision gets stable between the age of 18-21 so, we can plan for the surgery. In case of the woman, we do not any surgery in pregnancy or lactating or not taking any hormonal supplements cases. So, there are multiple surgeries. The most common is LASIK. It is the laser-based surgery which is performed on cornea.

It is a transparent section and does not have any blood supply. We remove the flap, correct the vision and we put the flap back in position. This is the most popular procedure. It is a safe procedure and for us, it only takes 15 mins to treat both the eyes. How do we know if the patient is suitable for LASIK? We need to make sure that the patient's cornea is normal in shape and thickness. This is checked by a test called corneal topography. If patients corneal is not as normal as told than we can plan PRK or advanced surface ablation. In this procedure, we deliver the laser energy directly onto the corneal surface. In this, we remove the topmost layer of the cornea which is called the epithelium and we deliver lasr energy directly to the corneal surface. And we put special contact lenses which help in healing topmost layer on top of the eye at the end of the procedure. This is good procedure who are unsuitable for LASIK.

Perfect clarity in patients is achieved in 1 month duration. And it takes 4-5 days for surface to heal. And it is also little painful for the patient. In few cases, LASIK and PRK is not an option. These are the patients who have very thin cornea or the patient has high refractive error or keratoconus. So, these patients can be planned for ICL. It is the special contact lens which is implanted in the eye. So, it stands for implantable compatible lenses. These are the lenses which are highly customized. These are extremely safe to use and have a very good visual outcome. We operate one eye at a time and we wait for a couple of days to treat another eye. After ICL, patient needs to avoid eye rubbing for 1-week duration because this is the time when the eye is at the healing stage. Direct contact with water should be avoided for 1 week after the procedure. But patient can get back to work even after the day of the procedure. So, all are good procedure but proper evaluation is must and it should be done by a corneal specialist and suitable procedure should be chosen for every individual patient.