Corneal transplants are performed for a multitude of reasons, and in Dr. Motwani’s opinion performed in many situations where there are better solutions or treatments available. Still, many patients have received corneal transplants and the visual problems that come with them. Corneal transplant creates significant new problems as a donor cornea from a cadaver must be used, which is not necessarily a matching shape to the recipient. The cornea is then sewn in to the recipient and virtually all will have some level of irregular astigmatism limiting vison and visual quality. This can lead to ghosting, multiple images, significant to extreme glare, streaking, and halos, and limitation of overall vision. Simply reading a line on an eye chart does not mean the vision is completely improved, and as many corneal transplants will improve the ability to read on a Snellen eye chart but the quality will be compromised.

It has become possible with topographic guided ablation utilizing the patented CREATE Protocol (Corneal Repair Epithelium and Topography Enhanced) to dramatically improve the irregular shape of a cornea transplant. This procedure utilizes the patented LYRA and San Diego Protocols, as well as the reduction of the irregularity masked by the epithelium (which normal topographic guided analysis cannot detect) which has also been patented by Dr. Motwani, to create as close to a virtually uniform cornea as possible. This can dramatically decrease visual symptoms such as ghosting, double and triple images, glare, halos, and other visual symptoms. It can also in many cases increase the quantity of vision as less light gets scattered.

With advancements in partial corneal transplants, such as transplant of the only the corneal endothelium, it may be possible to keep the newly reshaped anterior cornea long term or even permanently transplanting only the endothelium.