Surgery that reduces pupil to pinhole offers alternative to corneal transplants

Status: Not ApprovedChennai: When 67-year-old Mani K, Tambaram Chairman, came with a bleeding eye injury after badminton practice in his right eye a week ago, doctors at Dr Agarwal's Eye Hospitals knew that only surgery could restore his vision. However, they decided to avoid a corneal transplant, which is the treatment of choice for complete corneal tears. Instead, the team of doctors chose a surgical technique where they sutured the coloured part of the eye to reduce the size of the pupil to a pinhole."A day after the surgery, he read six out of the seven lines on the vision chart," said Senior Ophthalmologist and Dr Agarwal's Eye Hospital Chairman, Dr Amar Agarwal. The technique, called Pinhole Pupilloplasty, has been used to correct errors such as astigmatism and aberrations since 2018, but this was the first time it was used to prevent corneal transplantation. During the surgery, doctors suture around the iris to reduce the size of the pupil to a pinhole to improve vision. "It reduces the amount of light that enters the pupil, and the light is focused on the central part of the pupil, leaving an inverted shaft image in the retina, which is then interpreted by the brain," he said. The procedure enhanced visual acuity in the patient and is a less invasive alternative to corneal transplantation for certain patients," Dr Agarwal said. "Additionally, there is no fear of rejection like in the case of a corneal transplant," he said.When Mani read the lines on the eye chart clearly a day after the surgery, doctors said they knew they could bring down the need for corneal transplants at the hospital. "Over 54% of ocular emergencies and 32% of blindness cases in India result from trauma, often leading to corneal scarring, opacities, and astigmatism, which cause vision loss or blurring. In severe cases, corneal transplantation is typically performed, and yet many patients return with blurry vision. In patients who don't have injuries in the central part of the iris, pinhole surgery is a good option," said the hospital's Chief Clinical Officer, Dr Ashvin Agarwal. MSID:: 119259754 413 |