1 / 9

CORNEAL SURGERY

CORNEAL SURGERY. 1. Penetrating keratoplasty. 2. Keratoprosthesis. 3. Refractive surgery. Radial keratotomy. Photorefractive keratectomy (PRK). Laser in-situ keratomileusis (LASIK). Non-contact laser thermal keratoplasty. Penetrating Keratoplasty. 1. Indications.

yael-hodge
Download Presentation

CORNEAL SURGERY

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. CORNEAL SURGERY 1. Penetrating keratoplasty 2. Keratoprosthesis 3. Refractive surgery • Radial keratotomy • Photorefractive keratectomy (PRK) • Laser in-situ keratomileusis (LASIK) • Non-contact laser thermal keratoplasty

  2. Penetrating Keratoplasty 1. Indications • Optical (e.g. bullous keratopathy, dystrophies) • Tectonic (e.g. severe stromal thinning, descemetocele) • Therapeutic (e.g. severe keratitis) • Cosmetic 2. Adverse prognostic factors • Severe stromal vascularization • Absence of corneal sensation • Progressive conjunctival inflammation (e.g. pemphigoid) • Tear film dysfunction • Glaucoma

  3. Technique of penetrating keratoplasty a, b - Excision of host tissue Excision of donor tissue c - Fixation of donor tissue

  4. Signs of late graft rejection Epithelial Subepithelial opacities Linear epithelial opacity Endothelial Iritis and inflammation at graft-host junction Endothelial precipitates (Khodadoust line) Treatment • Intensive topical and periocular steroids • Occasionally systemic steroids

  5. Keratoprosthesis Indications Technique Insertion of artificial lenticule into corneal stroma Bilateral blindness from ocular pemphigoid, chemical burns or repeated graft failure Main complications • Retrolenticular membrane formation • Glaucoma

  6. Radial keratotomy • Decreases myopia by flattening cornea • Deep incisions from edge of optical zone to limbus Main indications Main complications • Stable myopia of up to 8D • Accidental perforation • Otherwise normal cornea • Intrastromal epithelial cysts

  7. Photorefractive keratectomy ( PRK ) Indications • Stable myopia up to 6D with astigmatism no more than 3D • Hypermetropia up to 2.5D Technique Main complication Subepithelial haze which usually resolves after 1-6 months Reshaping of cornea by excimer laser ablation of Bowman layer and anterior stroma

  8. Laser in-situ keratomileusis (LASIK) Indications - similar to PRK but corrects higher degrees of myopia Technique Complications • Wrinkles in flap • Thin flap of cornea fashioned • Cellular interface proliferation • Bed treated with excimer laser • Flap repositioned

  9. Non-contact laser thermal keratoplasty Indications • Patients over 40 years with hypermetropia up to 2D • Following overcorrection of myopia • Corneal curvature is steepened by application • of laser heat to stroma • Holmium laser spots applied to mid-cornea

More Related