Penetrating keratoplasty (PK) is a full thickness replacement of the cornea; including all of the layers from the outside to the inside. It is possible to replace one, or several, of the layers. These procedures are known as "lamellar keratoplasty." For example, if a patient has a scar localized in only the front portion of the cornea, and the back layers of the cornea remain healthy, then the surgeon may replace only the outer layer of the cornea with donor corneal tissue. In the newest form of layered transplantation, the goal is to replace the deep inner layers only, the most important of which is the endothelium. Remember that the endothelium is the layer of cells on the inside of the cornea that pump water out of the cornea in order to keep the cornea clear. This procedure is called "endothelial transplantation" or "Descemet's stripping endothelial keratoplasty (DSEK)." Your surgeon will discuss these alternative procedures if he or she feels that you are a candidate for one of them.
Astigmatic keratotomy is a surgical procedure which consists of making fine microscopic arcuate (curved) incisions, either singly or as a pair at optical zones of either 6 or 7 mm, or relaxing incisions at the limbus, which is the junction of the clear part of the eye (cornea) with the white (sclera) of the eye. These cuts known as "LRI" are made for the purpose of flattening the steepest part of the cornea in an attempt to obtain a more spherical cornea. AK permanently changes the shape of the cornea. Although the goal of AK is to improve vision to the point of not wearing glasses, this result is not guaranteed.
Pterygium and pinguecula are growths on the cornea - the clear front window of the eye - and the conjunctiva - the thin, filmy membrane that covers the white part of your eye (sclera). Both types of growths are believed to be caused by dry eye and environmental elements such as wind, dust and ultraviolet (UV) light.
This procedure is used to treat some of the most common Ocular Surface Diseases, including recurrent corneal erosion and epithelial basement membrane dystrophy. It is an in-office procedure that removes defective surface cells from the cornea so that healthy replacement cells can heal naturally from the periphery of the cornea.
Corneal Debridement is performed in the office. The procedure takes about 5 minutes. Your eye is given drops to “numb” the eye so you will not feel any discomfort. Your eye will be held open and the loose skin will be removed. Then, the cornea is gently rubbed with a device to polish the undersurface. The polishing of the cornea makes the new skin grow back firmly to the cornea, and greatly reduces the risk of the loose skin re-occurring.
Band keratopathy is a band across the central cornea, formed by the precipitation of calcium salts on the corneal surface. Calcium can be removed in a minor procedure room. After anesthetizing the eye, the cornea is bathed with EDTA solution. The surface epithelium and underlying calcium is than scraped off using a blunt spatula or careful application of a curved scalpel.
Temporary punctal occlusion. Sometimes it is necessary to close the ducts that drain tears out of the eye. This may be done temporarily with a plug that can be removed or will dissolve over a few days is inserted into the tear drain of the lower eyelid to determine whether permanent plugs can provide an adequate supply of tears.
Permanent punctal occlusion. If temporary plugging of the tear drains works well, then longer-lasting plugs may be used. This will hold tears around the eyes to improve lubrication. The plugs can be removed. Rarely, the plugs may come out spontaneously or migrate down the tear drain. Many patients find that the plugs improve comfort and reduce the need for artificial tears.