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HomeminewsKeyhole Corneal Punch Restores Vision

Keyhole Corneal Punch Restores Vision

Innovative corneal transplantation surgery using a keyhole shaped corneal punch has successfully restored vision to four out of 13 Australian patients in a clinical trial.

Professor Chandra Bala, Director of Surgery and ophthalmologist at personalEYES and an academic at Macquarie University, developed the keyhole shaped corneal punch and performed the surgery. The trial was financed by personalEYES, a network of corrective eye surgery clinics across NSW and Canberra, which invests more than AU$300,000 into research projects each year.

Professor Bala’s innovative corneal punch is attracting global recognition with awards that include the ASCRS 2019 film festival award in the category Refractive and cornea surgery, as well as the Michael Blumenthal Award at the 37th Congress of the European Society of Cataract and Refractive Surgeons in Paris.

Prof Bala said he was inspired to develop a new corneal punch because so little had been done to improve the traditionally used circular device in 30 years. Approximately 1,800 Australians require surgery for corneal transplantation every year.1 Nearly 90% of corneal transplants are effective,2 however, post-operative sight is not always optimal, with 20/20 vision either lacking or ultimately fading.

“The dated grafting technique was challenging, as the 20-50-micron tissue around the cornea is so delicate that touching it will destroy it,” says Professor Bala. “Therefore, many cornea specialists refuse to perform the surgery, regardless of the incredible potential outcome for the patient.

“With this in mind, we’ve created a device that has made a difficult surgery quite easy. The keyhole-shaped punch is a very fine instrument that can only transfer thin amounts of tissue at a time, with a tail to control it. The concept behind it is that you only replace what you need.”

Professor Bala said the innovation is a big step forward for specialists and doctors, and is reasonably priced, meaning any eye surgeon across the globe can perform the procedure with no additional costs.

“This innovation has transformed the way we approach this surgery. It provides the control and certainty which every surgeon needs, so they can effectively carry out a procedure to improve vision for people who have lost it.”

Patient Regains Independence

Sydney based retiree, Irene Tukuafu, was one of the four patients to successfully undergo the new procedure. Ms Tukuafu, who was diagnosed in 2017 with Fuchs Dystrophy, had reached the stage where she could no longer work or drive, and everyday life had become challenging. She had considered a corneal transplant but was concerned that she may not regain 20/20 vision post-surgery.

The result of the first procedure on Ms Tukuafu’s left eye was unsuccessful, however a second surgery on her left eye, followed by strict adherence to post-surgery instructions, proved successful. Prof Bala performed the surgery on Ms Tukuafu’s right eye nine months later with immediate success.

Ms Tukuafu said, “This new development and technique Prof Bala has implemented has not only given me my sight back, but has enabled me to regain my independence when no other options were being offered. I enjoy a great quality of life and am extremely grateful.”



  1. Centre for Eye Research Australia, ‘Corneal donation and transplantation’, see: www.cera.org.au/community/your-eyehealth/ corneal-donation-and-transplantation/. This page was last modified on 22 January 2018. 
  2. dspace.flinders.edu.au/xmlui/bitstream/handle/2328/37917/ ACGR%202018%20Report.pdf?sequence=3&isAllowed=y