La corneal microsurgery focuses on treating various diseases and injuries that affect this tissue crucial for vision. The cornea, located at the front of the eye, is transparent and avascular, and works like a watch glass to protect the inside of the eye and refract light allowing us to see clearly. Composed of five specific layers—the epithelium, Bowman's membrane, stroma, Descemet's membrane, and endothelium—each plays a vital role in maintaining corneal health and clarity.
La Corneal microsurgery uses advanced techniques and high-precision equipment to perform detailed and thorough interventions which can range from corneal transplants to less invasive procedures such as endothelial keratoplasty. These interventions are essential to restore vision in patients with conditions such as keratoconus, corneal scars, or post-cataract corneal edema, among others. At Clínica Nivaria, our priority is to use these sophisticated techniques to offer optimal results, significantly improving the vision and quality of life of our patients through personalized and carefully planned procedures.
What is corneal microsurgery?
Corneal microsurgery involves advanced surgical techniques to treat diseases and injuries of the cornea, the transparent front surface of the eye responsible for light refraction and eye protection. This type of surgery includes procedures such as corneal transplants, intracorneal ring implants, and keratoplasty, all designed to restore vision and improve eye health.
What are common conditions that require corneal microsurgery?
Conditions that may require corneal microsurgery include keratoconus, corneal scarring, severe corneal infections, physical damage to the cornea, and corneal edema that does not respond to less invasive treatments.
What is a cornea transplant and when is it necessary?
A corneal transplant, also known as keratoplasty, is a surgical procedure that involves replacing a damaged or diseased part of the cornea with healthy corneal tissue from a donor. It is necessary when the cornea becomes opaque or extremely thin, compromising vision and not amenable to improvement with other therapies.
How is a cornea transplant performed?
The corneal transplant procedure varies depending on the specific technique used. Techniques include penetrating corneal transplant (replacing all layers of the cornea) and lamellar keratoplasty (replacing only some layers). Local or general anesthesia is used, and the donor tissue is sutured into place, allowing integration into the patient's eye.
What is the success rate of a cornea transplant?
The success rate of corneal transplants is high, especially for patients without other eye diseases. Advances in surgical techniques and postoperative care have significantly improved long-term results and visual clarity.
What are the risks associated with corneal microsurgery?
Although generally safe, corneal microsurgery carries risks such as graft rejection, infections, healing problems and, rarely, vision loss. These risks are carefully discussed during the preoperative consultation.
How long does recovery take after corneal microsurgery?
Recovery time may vary depending on the specific procedure and the patient's general health. It may take from a few weeks to several months for complete recovery and stabilization of vision.
What postoperative care is necessary after corneal microsurgery?
Postoperative care includes the use of anti-inflammatory medications and antibiotics, regular follow-up with the ophthalmologist, and eye protection to prevent injury while the cornea heals. Detailed instructions are provided for each patient based on their specific procedure.
Can I stop wearing glasses or contact lenses after corneal microsurgery?
Many patients experience significant improvement in their vision and are able to reduce or eliminate their dependence on glasses or contact lenses. However, the result depends on the reason for the procedure and the patient's eye condition.
How do I know if I am a candidate for corneal microsurgery?
A complete evaluation by a specialized ophthalmologist is necessary to determine if you are a candidate for corneal microsurgery. This will include a detailed examination of your cornea and overall eye health, along with discussions about your expectations and visual needs.
Keratoconus
Keratoconus represents one of the most frequent degenerative corneal pathologies in our environment. It is estimated that there will be around five hundred undiagnosed patients on our island. This disease is characterized by the appearance of a progressive deformity (ectasia) at the level of the corneal structure (our external lens) due to a congenital weakness.
The suspicion of suffering from keratoconus is established when a young person with high astigmatism and myopia in their glasses does not achieve good vision with the need for frequent and constant graduation. These symptoms are shown to be aggravated with repeated eye rubbing.
This disease in advanced stages can cause legal blindness despite the usual means for its correction (glasses, contact lenses). In these stages the classic practice so far indicated the performance of a corneal transplant, with the consequent disorder to the patient and the health expenditure involved, but the emergence of new techniques have shown, in those cases indicated, that its performance stops the progression of this degenerative process, avoiding in a high percentage of patients the performance of transplants, and improving the visual quality and tolerance of other treatments, such as contact lenses.
Specifically, one of these techniques, the implantation of intracorneal rings, has been carried out for years with excellent results to stop and stabilize the disease. These are circular segments made of biocompatible material that stabilize the cornea due to its structural effect and regularize astigmatism.
If they are indicated correctly and are performed with the appropriate technique, the percentage of associated complications is minimal.
Another of the novel techniques consists in applying ultraviolet radiation radiation type A (UVA rays) on the cornea to which we have previously treated with vitamin B2 (riboflavin). This manages to “harden” these corneas that due to their weakness suffer from keratoconus.
Pterygium or pernal
Pterygium is a disease that affects the conjunctiva and cornea. The conjunctiva is a thin transparent membrane that covers the sclera (the white portion of the eye). It is there where the disease begins: there is an exaggerated growth of the conjunctiva in the portions exposed to the sun.
It can produce a wide variety of symptoms that can range from the sensation of a foreign body and red eye, to the alteration of vision due to the induction of astigmatism or even invasion of the visual axis, it can also be aesthetically annoying.
In the initial phases, when the sensation of burning and dryness is light, it can be mitigated with lubricants and vasoconstrictors. In advanced stages surgery is required to eliminate the pterygium and replace it with a healthy conjunctiva. Each surgery is different depending on the particular needs of the patient.
In the Canary Islands we have the highest incidence in Spain in cases of pterygium, which is common in eyes that have been subjected to sun overexposure without adequate protection. It is essential for its prevention that we use sunglasses that prevent the radiation of ultraviolet rays. Failure to perform this type of surgery in advanced cases can lead to progressive loss of vision.
