Corneal transplants can be amazing, vision restoring procedures in cases where damage to the cornea is simply too severe to save the cornea with other procedures such as laser reconstruction with the CREATE Protocol. Unfortunately, by nature every cornea transplant has an irregular corneal shape that will limit vision to some extent. This is due to the fact that the corneal shape from the donor will not necessarily match the shape of the recipient. Corneas are obtained by availability; they are not matched by shape in any way for the recipient. Each new cornea is sewn in my hand, and to get an even shape would require every stitch to be perfectly placed as apposed to the other, the same depth, and the same length as all the others. This is simply impossible with hand sewn sutures so by every transplanted cornea is irregular.
It is possible to laser reconstruct cornea transplants to remove irregularity and improve quality and quantity of vision. This is performed by mapping and reconstructing the cornea and the original incorrect laser shape into a new even space by removing the irregular tissue segmentally micron by micron to make a regular shape again. This is usually after any necessary suture removal from the transplant has been performed as the sutures will affect the final shape to be reconstructed.
Dr. Motwani has also invented the procedure for treating the part of the corneal irregularity that the eye tried to “fix” itself, by variably changing the epithelial thickness (the clear skin on top of the cornea) to mask low and high spots of irregularity. These masked irregularities cannot be detected by the topography systems that create the repair map. By using a trans-epithelial approach customized by depth of epithelial compensation, a greater amount of the irregularity can be removed. This is the CREATE Protocol (Corneal Repair Epithelium and Topography Enhanced). This has been validated in peer-reviewed original research clinical studies publications, as well as multiple United States patents and patents pending.
https://cornearevolution.com/publications
The CREATE Protocol procedure reconstructs the cornea micron by micron into a more ideal, uniform shape with a reduction in overall corneal irregularity, whether surgery induced or natural biologic. It is difficult with current technology to exactly fine tune the prescription of the new improved corneal shape, so a second simple residual refractive correction enhancement is scheduled as part of a CREATE Protocol procedure 4 months after the reconstructive procedure.
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