Although the ability to treat corneal ulcers, corneal infections, and traumatic corneal damage is light years ahead of even a few decades ago, often the treatment of the original problem still results in a significant corneal scar, corneal irregularity, and irregular astigmatism. We have even seen damage to the cornea resulting in scars and irregularity from contact lenses and scleral lenses meant to help treat patients with corneal irregularity.
Oftentimes, scars are diagnosed by ophthalmologists as “full thickness” and a cornea transplant is recommended. Corneal transplants have a failure rate of 40% across 10 years, are irregular by nature causing new vision issues, and can reject or fail even after years. When necessary, they are an amazing means of restoring vision, but in many cases the patient’s own cornea can be repaired rather than a transplant performed.
Most scars are not “full thickness,” and this allows for the removal of the opaque tissue by laser in a precise manner until clear cornea is reached. This is the first step of scar reduction and repair.
Once clear or clearer cornea is reached, the irregularity must be treated with topography guided ablation to make a more normal, uniform cornea again. This is laser corneal reconstruction of the irregular shape caused by the original cause of the scar- infection, trauma, surgery, etc. Sometimes the depth of the scar is not too deep and opaque tissue removal and corneal reconstruction can be performed in one step instead of two.
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. In fact, the imaging maps created for the reconstruction treat the overall corneal irregularity including ones that could just be natural biologic in origin.
Finally, the refractive error must be dealt with. The loss of tissue from the original cause as well as the tissue removed to reduce the scar will cause a refractive error. This must also be treated.
Scar reduction is usually a 3 step, sometimes 2 step process, but the results have been remarkable. We have taken eyes that could see only fingers and shadows and brought back 20/25, 20/30, 20/40 vision.
Although the ability to treat corneal ulcers, corneal infections, and traumatic corneal damage is light years ahead of even a few decades ago, often the treatment of the original problem still results in a significant corneal scar, corneal irregularity, and irregular astigmatism. We have even seen damage to the cornea resulting in scars and irregularity from contact lenses and scleral lenses meant to help treat patients with corneal irregularity.
https://drmotwani.com/trauma-and-infection-repair/
Oftentimes, scars are diagnosed by ophthalmologists as “full thickness” and a cornea transplant is recommended. Corneal transplants have a failure rate of 40% across 10 years, are irregular by nature causing new vision issues, and can reject or fail even after years. When necessary, they are an amazing means of restoring vision, but in many cases the patient’s own cornea can be repaired rather than a transplant performed.
Most scars are not “full thickness,” and this allows for the removal of the opaque tissue by laser in a precise manner until clear cornea is reached. This is the first step of scar reduction and repair.
Once clear or clearer cornea is reached, the irregularity must be treated with topography guided ablation to make a more normal, uniform cornea again. This is laser corneal reconstruction of the irregular shape caused by the original cause of the scar- infection, trauma, surgery, etc. Sometimes the depth of the scar is not too deep and opaque tissue removal and corneal reconstruction can be performed in one step instead of two.
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. In fact, the imaging maps created for the reconstruction treat the overall corneal irregularity including ones that could just be natural biologic in origin.
Finally, the refractive error must be dealt with. The loss of tissue from the original cause as well as the tissue removed to reduce the scar will cause a refractive error. This must also be treated.
Scar reduction is usually a 3 step, sometimes 2 step process, but the results have been remarkable. We have taken eyes that could see only fingers and shadows and brought back 20/25, 20/30, 20/40 vision.
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
https://drmotwani.com/dr-manoj-motwani/
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.
We have created a YouTube channel with dozens of videos documenting patient interviews, surgeries, and how treatments work. Please follow the link below to watch
https://drmotwani.com/video-gallery/
https://drmotwani.com/patient-resources/
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.
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.
We have created a YouTube channel with dozens of videos documenting patient interviews, surgeries, and how treatments work. Please follow the link below to watch
