Corneal Disease

Corneal Disease Therapeutic Procedures

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The excimer laser may provide a novel modality in the treatment of a number of superficial corneal disorders. This treatment is known as a phototherapeutic keratectomy or PTK.

Whether PTK eye surgery is used alone or as an adjunctive strategy in traditional corneal surgical techniques, a number of disorders affecting the corneal surface may be successfully treated by taking advantage of the excimer laser’s ability to meticulously remove superficial corneal tissue.

These include a variety of corneal degenerations and dystrophies, corneal irregularities, and superficial scars. While some of these conditions, heretofore, could be treated by mechanical superficial keratectomy techniques, PTK may minimize tissue removal and surgical trauma.

The smoother stromal surface achieved by the excimer laser procedure may improve the surface smoothness of the cornea, improve postoperative corneal clarity and decrease postoperative scarring, and facilitate subsequent epithelial adhesion.

Moreover, superficial corneal disorders which, in some cases, would otherwise require a cornea transplant may be amenable to treatment with the PTK procedure.

Unlike the excimer laser PRK or LASIK technique for correction of nearsightedness, PTK treatments will vary with different corneal disorders, and the clinical goals of the procedure may, likewise, vary depending upon the patient’s symptoms.

Complication Management

If you have had problems with vision correction surgery elsewhere, we would be happy to try to help you. We see many patients with such problems. A complete evaluation usually will diagnose your problem and we then can formulate a plan to improve your situation.

Diagnostic Technologies

At the Cornea and Laser Eye Institute, we offer a complete array of sophisticated, state-of-the-art diagnostic technologies to assess your problem and determine the proper course of treatment.

These diagnostic tools include:

Corneal topography instruments to assess your corneas optical surface and architecture (including the new Pentacam HR, EyeSys, Keratron, HD Analyzer, and PAR units). Each of these maps the cornea in slightly different ways, giving information useful to your care.

Wavefront analysis of the eyes optical system and assessment of aberration profile. In addition to nearsightedness and astigmatism, quality of vision is dependent on the amount of “static” light in your eye’s optical system. By mathematically assessing your focusing pathways, we are able to better diagnose and treat optical problems both before and after surgery.

Ocular coherence tomography (OCT). OCT is a new technology that can produce high-resolution 3-dimensional pictures of the various structures of the eye.

It is used in LASIK and corneal diseases to assess the different layers of the cornea, including the thickness of the corneal epithelium, thickness and regularity of the LASIK flap, and quality of the collagen pancake structure of the cornea in keratoconus.

Pupil size. Infrared pupillometry accurately assesses your pupil diameter in low-light conditions.

Contrast sensitivity. This is a measurement of quality of vision and the ability to pick up objects of low contrast.

Binocularity testing. This tests the way in which your two eyes work together.

Corneal thickness (ultrasonic pachymentry). This may give useful information in determining which procedure is best for you and in diagnosing a number of corneal conditions, including keratoconus.

New Reichert Optical Response Analyser. This is a brand new instrument just introduced. It measures the biomechanics (eg elasticity, rigidity, and flexibility) of the cornea.

This may allow for better analysis of LASIK safety in your case and may also aid in planning treatment based on your specific corneal structure.

Specular microscopy. This is a microscopic assessment of the number and quality of your corneal cells.

Refraction (determination of prescription). Accurate measurement of refraction is essential for a successful LASIK eye surgery procedure.

The goal of our comprehensive evaluation is multifold, depending on your problem. Before surgery, these tests help determine if you are a good candidate and, if so, what is the best procedure to correct your vision.

After surgery, we are able to accurately assess your outcome. Finally, in patients referred to us after surgery, we can assess any problems and suggest a course of treatment.

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