Consultant Ophthalmic Surgeon
Complex Cornea
Surgery
What is a cornea?
The cornea is the clear tissue covering the front of the eye. It is the main focusing element of the eye. Light shines through it to the back of the eye allowing us to see.
| Corneal Graft (transplant)
If your cornea becomes cloudy due to disease, injury, and infection you will find it harder and harder to see. It might be then the case that a corneal graft surgery is needed.
Why do I need a corneal graft?
Sometimes through injury, infection, or some inherited condition (such as keratoconus) the cornea may lose its natural transparency or normal shape, leading to blurred vision. In many cases glasses or contact lenses may help to see more clearly, but there are times when these do not work, and the cornea needs to be replaced (graft/transplant).
This is a surgical procedure which replaces a disc shaped segment of cornea typically about seven to eight millimetres (mm) in diameter, with a similarly shaped piece of donor cornea.
There are 3 types of corneal graft surgery:
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Deep anterior lamellar corneal graft - if only the surface layers of the cornea are unhealthy these layers are removed and replaced by a graft.
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Corneal endothelial graft - if it is the inside layer of the cornea that is unhealthy, only this is removed and replaced by a graft.
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Penetrating corneal graft - if the whole thickness of the cornea is unhealthy, the patient’s whole cornea is removed and replaced with a graft.
Mr Kopsachilis will be able to advise which is the most appropriate procedure for you, after discussing your clinical history and any examination results you might have.
| Complex Corneal Surgery
| Pterygium and pterygium surgery
What is a pterygium?
A pterygium is a tissue that can grow from the conjunctiva onto the cornea (the clear window at the front of the eye). It usually grows very slowly over many years and it is more common in people who have been exposed to a lot of sunlight during their lifetime.
Some of the symptoms are the following:
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dissatisfaction with the cosmetic appearance of the eye
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redness
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discomfort in the eye, which is usually a dry or gritty sensation, caused by drying of the normal tear film on the surface of the pterygium or adjacent to it
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in extreme cases a pterygium can grow over the central part of the cornea and can cause blurred vision, or the scarring may restrict the movement of the eye, causing double vision
Treatment options
If pterygium grows to affect sight, then it is recommended to be surgically removed. The main reason for removing a pterygium is to prevent future loss of eyesight by stopping the pterygium from growing over the central area of the cornea. Other symptoms such as redness or discomfort are not as easily treated by surgery and are best treated, where possible, by simple methods such as the use of lubricant eye drops.
In some cases, pterygium may return despite their proper removal. There is then need for additional surgical techniques. This could include the use of other transplantation materials (grafts), or radiation treatment to try to prevent another recurrence. The choice of techniques depends on the details of each individual case. However, in general, the risks of surgery for a recurrent pterygium tend to be higher and success rates lower.
|Corneal Abrasion
How will I know that I have an abrasion?
A corneal abrasion happens when the surface of the cornea is damaged. If the nerves are exposed the eye becomes painful. With treatment, corneal abrasions heal within one to two days. Larger or deeper abrasions may take longer.
You may have a corneal abrasion if you have one or more of the following symptoms:
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pain or a foreign body sensation (the feeling you have something in your eye)
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watering or a sticky discharge from your eye
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light sensitivity (your eye hurts when exposed to daylight)
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redness
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swollen eyelids
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reduced vision
A corneal abrasion is a common eye injury which can happen at home, at work, or during your leisure time. Commons causes include:
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foreign bodies (such as small particles) on the surface of the eye, or underneath the eyelid • scratches caused by fingernails, plants, twigs, paper, or card
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blunt injury, for example being hit with a squash ball or fist
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contact lenses
What is the treatment?
Your eye will be examined by the doctor or a nurse using a slit lamp microscope to assess your injury (a local anaesthetic drop to numb the area may be needed to do this). The treatment that you are given will depend on the size and depth of your corneal abrasion. You may be given antibiotic ointment which will be put into your eye and a pad applied. This allows your eye to rest and prevents the eyelid from rubbing away the new cells that are repairing the cornea. Alternatively, you may be given a drop which will dilate (make bigger) the pupil to relieve muscle spasm of the iris (the coloured part of the eye). Again, a pad may be applied.
| Further information on Complex Corneal Surgery
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