Sunday, 3 November 2013

Sarojini's Case of Fuchs' Endothelial Dystrophy (FED)

Mikkili Sarojini, 60, and her husband worked as daily labour in their village Kondepadu in Pathipadu mandal, Guntur district. Sarojini had Fuchs' endothelial dystrophy (FED), characterized by an asymmetrical, bilateral, slowly progressive edema of the cornea in elderly patients, more common in women than men. She was referred to LVPEI Hyderabad by the doctors in Guntur district and had undergone PK (Penetrating Keratoplasty) and corneal transplant along with cataract surgery in 2002. Post the surgery performed by
Dr Prashant Garg, Sarojini did well for five years. A graft rejection episode in 2007 necessitated a repeat corneal transplant.

In 2013, there was a problem of blurred vision in the same eye, diagnosed as failed graft and she underwent Descemets Stripping Endothelial Keratoplasty (DSEK) corneal transplant, carried out for patients with persistent corneal swelling and poor vision. With DSEK procedure, only one of the innermost layers of tissue, the endothelium, and its membrane, the Descemet's membrane, are stripped off the cornea and replaced with a layer of healthy inner lining of a donor tissue. A thin button of donor tissue with only the endothelial cell layer is inserted onto the back surface of the patient's cornea. Post the operation, eye drops were prescribed and the happy couple is now on its way back to their village. The significant improvement in Sarojini's eyes has become a story of hope for many inhabitants of nearby villages.

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