Course on Lamellar Corneal Surgery Cornea Clinic Apollo Hospitals, Hyderabad, India

Course Director Dr Rajesh Fogla DNB, FRCS, MMed www.corneaclinic.com

Corneal surgery has witnessed a resurgence of lamellar surgical procedures in the past decade. Although the concept of lamellar reshaping has been used worldwide in refractive surgery in the form of LASIK procedure, selective replacement of the corneal layers was not popular compared to conventional full thickness keratoplasty. Penetrating keratoplasty was still considered to be the Gold Standard. Out of the box thinking led to development of both anterior and posterior lamellar corneal surgical procedures. A variety of corneal disorders such as Keratoconus, Corneal stromal dystrophies, and Scars not involving the Descemets Membrane, for which penetrating keratoplasty was being performed, healthy endothelial layer of the host was unnecessarily sacrificed. Anterior Lamellar Keratoplasty preserves the endothelial layer and thereby eliminates the risk of endothelial rejection. Full thickness grafts for endothelial dysfunction has problems such as delayed visual recovery due to astigmatism, poor tectonic wound integrity, suture related complications etc. Lamellar replacement of the endothelial layer, preserves the surface contour and results in faster visual recovery, and increased tectonic stability. Shifting from conventional full thickness corneal transplantation to lamellar surgical procedures requires the corneal surgeon to once again go through the process of learning curve of these newer surgical techniques. As the learning curve is steep, most surgeons may find operative complications as stumbling blocks in adopting these newer surgical procedures. This course is designed to provide an overview of the newer lamellar corneal surgical procedures in a step-wise manner, with one to one interaction with the course attendees. The course is conducted by Dr Rajesh Fogla, who has been performing lamellar corneal surgeries since 1997. He has mastered the technique of both anterior and posterior lamellar corneal surgery, and has developed instruments to make these procedures easier to perform. This course on lamellar corneal surgery was initiated for the first time in India, in September 2008 and since then 3 batches have successfully attended this course. The course consists of didactic lectures with videos of various techniques of anterior and poster lamellar corneal surgery (manual LK, ALTK, Big Bubble DALK & DLEK, DSEK, DSAEK, DMEK), instrumentation, wet lab training on donor eyes, live surgery (anterior and posterior lamellar), and examining clinical cases. All attendees will receive DVD and other resource materials which will be useful for easy reference whenever required.

Course on Lamellar Keratoplasty Outline Day 1 9.30 am to 1pm : Didactic interaction - Surgical technqiues of anterior lamellar keratoplasty (ALK), including manual ALK, Automated ALK, DALK Big Bubble technique. - Candidates examine all surgical instruments - Surgical videos, complications & their management. 1 - 1.30 : Lunch 1.30 to 5pm: Wet lab training on anterior lamellar keratoplasty surgery. Day 2 9.30am to 12pm: Clinical cases evaluation in Outpatient Department 12pm to 5pm : Live Surgery DALK manual & BB, DSAEK, DMEK Day 3 9am : Review post op cases 10am to 1pm: Didactic interaction - Posterior lamellar keratoplasty, including DLEK, DSEK, DSAEK, & DMEK. - Surgical videos, Complications and their management. 1 to 1.30pm : Lunch 1.30 to 5pm: Wet lab training on posterior lamellar keratoplasty