Corneal microsurgery focuses on treating various diseases and injuries that affect this tissue, which is crucial for vision . The cornea, located at the front of the eye, is transparent and avascular, and functions like the crystal of a watch to protect the inside of the eye and refract the light that allows 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.
Corneal microsurgery utilizes advanced techniques and high-precision equipment to perform detailed and meticulous interventions , ranging from corneal transplants to less invasive procedures such as endothelial keratoplasty. These interventions are essential for restoring vision in patients with conditions such as keratoconus, corneal scarring, and post-cataract corneal edema, among others. At Clínica Nivaria, our priority is to use these sophisticated techniques to deliver optimal results, significantly improving our patients' vision and quality of life 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 clear front surface of the eye responsible for refracting light and protecting the eye. 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 the 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 corneal transplant and when is it necessary?
A corneal transplant, also known as keratoplasty, is a surgical procedure that involves replacing a damaged or diseased portion of the cornea with healthy corneal tissue from a donor. It is necessary when the cornea becomes opaque or extremely thinned, compromising vision and not amenable to improvement with other therapies.
How is a corneal transplant performed?
The corneal transplant procedure varies depending on the specific technique used. Techniques include penetrating corneal transplantation (replacement of all layers of the cornea) and lamellar keratoplasty (replacement of only some layers). Local or general anesthesia is used, and the donor tissue is sutured in place, allowing it to integrate with the patient's eye.
What is the success rate of a corneal 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 outcomes and visual clarity.
What are the risks associated with corneal microsurgery?
Although generally safe, corneal microsurgery carries risks such as graft rejection, infection, healing problems, and, in rare cases, vision loss. These risks are carefully discussed during the preoperative consultation.
How long does recovery take after corneal microsurgery?
Recovery time can vary depending on the specific procedure and the patient's overall health. It can take anywhere from a few weeks to several months for full recovery and stabilization of vision.
What postoperative care is necessary after corneal microsurgery?
Post-operative 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 a significant improvement in their vision and can reduce or eliminate their dependence on glasses or contact lenses. However, the outcome depends on the reason for the procedure and the patient's eye condition.
How can I find out if I am a candidate for corneal microsurgery?
A comprehensive evaluation by a specialist 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 is one of the most common degenerative corneal diseases in our region. It is estimated that there are around five hundred undiagnosed patients on our island. This disease is characterized by the progressive deformity (ectasia) of the corneal structure (our external lens) due to a congenital weakness.
Keratoconus is suspected when a young person with high astigmatism and myopia does not achieve good vision with their glasses, requiring frequent and constant adjustments to their prescription. These symptoms have been shown to worsen with repeated eye rubbing.
In advanced stages, this disease can cause legal blindness despite standard corrective measures (glasses, contact lenses). Until now, traditional practice at these stages has indicated a corneal transplant, with the resulting disruption to the patient and the associated healthcare costs. However, the emergence of new techniques has demonstrated that, in appropriate cases, these procedures halt the progression of this degenerative process, preventing the need for transplants in a high percentage of patients and improving visual quality and tolerance of other treatments, such as contact lenses.
Specifically, one of these techniques, the implantation of intracorneal rings, has been performed for years with excellent results in halting and stabilizing the disease. These are circular segments made of biocompatible material that stabilize the cornea through their structural effect and correct astigmatism.
If they are indicated correctly and performed with the appropriate technique, the percentage of associated complications is minimal.
Another innovative technique involves applying ultraviolet A radiation (UVA rays) to the cornea, which has been previously treated with vitamin B2 (riboflavin). This helps to "harden" these corneas, which suffer from keratoconus due to their weakness.
Pterygium or pernal
Pterygium is a condition that affects the conjunctiva and cornea. The conjunctiva is a thin, transparent membrane that covers the sclera (the white part of the eye). The condition begins there: an overgrowth of the conjunctiva occurs in the areas exposed to sunlight.
It can produce a wide variety of symptoms that can range from a foreign body sensation and red eye, to altered vision due to the induction of astigmatism or even invasion of the visual axis, and it can also be aesthetically bothersome.
In the initial stages, when the burning and dryness are mild, it can be alleviated with lubricants and vasoconstrictors. In advanced stages, surgery is required to remove the pterygium and replace it with healthy conjunctiva. Each surgery is different depending on the patient's specific needs.
The Canary Islands have the highest incidence of pterygium in Spain, a condition common in eyes that have been overexposed to the sun without adequate protection. Wearing sunglasses that block ultraviolet radiation is essential for prevention. Failure to perform this type of surgery in advanced cases can lead to progressive vision loss.
