Corneal endothelial keratoplasty

The recent trends in corneal transplantation technique had seen a paradigm shift from full thickness penetrating keratoplasty to partial thickness lamellar corneal transplantation to facilitate rapid visual rehabilitation in patients suffering from corneal blindness.

Our clinical research group in Cambridge, led by Professor Madhavan Rajan and based at Cambridge University Hospitals, has developed innovative approaches to endothelial keratoplasty in the last ten years. This includes a novel technique to prepare ultrathin corneal transplants from donor corneas to improve visual outcomes in patients undergoing endothelial keratoplasty (Microthin DSAEK). This project had received the NHS Enterprise East innovation award.

In addition, we have conducted research on the safety threshold of vital dyes and their use in DMEK corneal transplantation. The results had a positive influence on reducing intraoperative and post-operative complications in DMEK procedures with improved patient outcomes.

Currently, we have completed the recruitment phase to the randomised clinical trial comparing patient outcomes between Microthin DSAEK and DMEK procedures. The results of this trial are expected to inform the corneal transplant community, eye banking organisations and patients regarding the relative merits of the specific techniques in order to improve visual results following transplantation.

Our continued efforts to improve patient outcomes following corneal transplantation has resulted in 97% transplant survival rates in Cambridge, which is one the best in the country.

Madhavan Rajan MD FRCS FRCOphth
Consultant Ophthalmologist
Clinical lead – Cornea and Cataract Service, Addenbrooke's Hospital