Corneal Surgery

Procedures for Corneal Surgery

The cornea is a thin, clear tissue which acts as the front wall of the eye and plays a vital role in the transmission of light from the outside world into the eye.  There are many eye diseases that can damage the precision or injure the shape of the cornea and put off the uninterrupted passage of light through it.

Moreover, the cornea may play a role in a refractive error of the eye; this will result in a reprehensively focused image on the retina.  Many surgical options are available for the treatment of corneal diseases and correcting refractive errors.

The Unhealthy Cornea

The cornea becomes unhealthy in many ways.

  • An injury to the cornea can cause scarring.
  • A scar, which is intense and white, can straightforwardly hamper the passage of light through the cornea.
  • A scar can cause the shape of the cornea to turn abnormal and distorted, which can cause incoming light to be bent in an irregular way as it passes through the cornea.
  • Warping or distortion of the cornea can also happen in certain diseases, such as keratoconus, wherein some parts of the cornea will be abnormally thin or irregularly shaped.
  • Disease or injury can also cause swollen cornea. When the cornea swells, it will be cloudy, thus impeding the clear passage of light.

Penetrating Keratoplasty

As the cornea becomes severely swollen, scarred or warped, light cannot simply pass through to the retina, and vision is lost.  Many kinds of diseases can result in a cloudy or warped cornea, like corneal swelling after eye surgery, Fuchs Dystrophy, Keratoconus or scarring after corneal trauma. In such cases, a total replacement of the cornea may be required.

The surgical procedure to accomplish a complete corneal transplant is called Penetrating keratoplasty (PK).  During a PK procedure, the whole cornea is removed and replaced with a donor cornea.  The donor tissue is secured in place with many sutures which are finer than a human hair, typically placed in a spoke like fashion around the outside edge of the transplant. These sutures stay in place for several months, and then are slowly removed during the course of one to two years.

There are many eye medications that will be required after a corneal transplantation, and a lifetime use of eye drops and regular eye examinations is required in order to keep the transplant healthy and to prevent rejection.

DSEK – Descement Stripping Endothelial Keratoplasty.

In DSEK, the endothelial lining of the cornea is taken away by making a small incision in the eye and by replacing it with a small disc of endothelial cells from a donor.  The replacement of the malfunctioning endothelial cells will allow the cornea to regain the lost function of the endothelial cells.   DSEK is done through small incisions and has a comparatively fast recovery period. 

Usually, the cornea can be significantly cleared by 4 to 6 weeks after the surgery. 

Superficial and Phototherapeutic Keratectomy

When scar tissue appears on the surface of the cornea, it can be effectively removed through superficial keratectomy.  In this type of surgical procedure, the eye is numbed with eye drops. The corneal epithelial surface cells are the first to be removed, and then scar tissue will be peeled off the front of the cornea. The epithelial cells then heal over the wound, and this will usually happen in about 5 to 7 days.