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Cornea Clinic - Eye Department - Apollo Hospitals, Jubilee Hills, Hyderabad 500 033, A P,  INDIA
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Cornea Clinic, at Apollo Health City, Hyderabad, India -  conducted a 3 day course on Lamellar Corneal Surgery for the first
time in India September 5th - 7th 2008.

With recent advances in corneal surgery, both anterior and posterior lamellar corneal surgery are being performed more
commonly compared to conventional full thickness corneal transplantation surgery.

Deep anterior lamellar keratoplasty or DALK procedure has the greatest advantage of retaining the host endothelium
thereby eliminating the risk of endothelial rejection of the donor tissue. This has revolutionized the management of corneal
replacement surgery in advanced keratoconus cases, wherein healthy endothelium of young patients need not be sacrificed
to restore corneal anatomy. Various other disorders, such as corneal dystrophies, scars etc which spare the endothelium
can be successfully managed with DALK surgery.

Endothelial keratoplasty (EK), commonly termed DSEK or DSAEK.. helps replace the dysfunctional endothelium in cases of
bullous keratopathy, Fuchs' endothelial dystrophy etc cases. Absence of surface incisions and sutures, allows faster visual
recovery, and provides greater tectonic stability.

Various surgical techniques exist, however each has its own learning curve, and most corneal surgeons are unable to start
performing lamellar procedures due to lack of initial training facility. Complications in the initial cases also act as stumbling
blocks for surgeons who start with these surgical procedures. This course is designed to provide a detailed insight into both
anterior and posterior lamellar corneal surgical procedures.

Limited number of candidates are taken for this course. This allows greater interaction with the candidates during the
lectures, wet lab training, and during surgical procedures. Candidates are provided with a step by step approach to the
surgical procedures. Various surgical instruments are displayed, with detailed explanation as to their importance in the
surgical procedures. Candidates review unedited tapes of prior surgeries to understand various steps, and management of
intraoperative complications. Live surgery helps them understand the arrangement in the operation theatre and how to train
the assisting nurse. Candidates also review post operative patients at various stages of follow up. Extensive wet lab training
is provided both on animal eyes and donor corneo-scleral rims mounted on artificial anterior chamber.
First batch of candidates for Course on Lamellar Corneal Surgery - September 5th -7th 2008
Wet lab session in progress
Discussion on surgical procedures
Cornea Clinic also acquired the Amadeus ALTK
system for the first time in India.

All candidates attending the course were able to get
hands on experience with this instrument system in
the Wet Lab.

Mr Marc Zurcher from SIS medicals, Switzerland was
also present to explain details of this instrument
system consisting of the artificial chamber and
various heads for the Amadeus 2 microkeratome.
Dr Fogla was the first person to start with
Endothelial Keratoplasty surgery in India in
May 2004, after basic training with Dr Mark
Terry at Portland, USA. He started with Deep
Anterior Lamellar Keratoplasty surgery back
in 1997, after a short training with Dr Chad K
Rostron at St Georges Hospital, London, UK.
Since then Dr Fogla has been participating
as a speaker in various courses and wet lab
training programmes  at the American
Academy of Ophthalmology and American
Society of Cataract and Refractive Surgeons
with Dr Mark Terry, & Dr Mohammed Anwar.
12th - 14th June 2015, then September & December
future Courses on Lamellar Corneal Surgery