Dr Amar Agarwal finds alternative to corneal transplants

CHENNAI: Dr Amar Agarwal, an ophthalmologist and the chairman of Dr Agarwals Eye Hospital group, has introduced pinhole pupilloplasty (PPP), a simple innovation that offers a simple and highly effective alternative to corneal transplantation.

PPP can prove to be a solution to the global shortage of donor corneas that keeps millions visually impaired. In many cases where corneal transplantation is risky or impractical, PPP serves as a safe and effective alternative.

The procedure can significantly improve vision in patients with corneal irregularities caused by conditions like keratoconus, scarring, or higher-order aberrations, often removing the need for glasses or contact lenses. PPP is a minimally invasive surgical procedure in which a small, custom-sized central opening (pinhole) is created in the iris to filter incoming light.

This pinhole blocks out distorted peripheral rays and channels only the focused central rays, directing them precisely onto the retina, dramatically improving visual clarity in eyes with irregular corneas. Unlike corneal transplantation, which involves complex surgery, long healing time, and risk of rejection, PPP is a simple, quick-healing, low-risk and effective alternative.

The procedure requires only basic surgical tools and does not rely on expensive equipment or donor tissue. The procedure is not suitable for eyes with central corneal opacities or progressive corneal diseases unless stability is ensured.

Dr Amar Agarwal said, “Over 2 crore people worldwide live with several forms of visual impairment, and many of them will never receive a donor cornea. With the backlog of corneal blindness steadily increasing, PPP offers a timely, scalable, and practical alternative.”