Corneal Disease

Therapeutic Procedures

Happy middle aged couple

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.

KAMRA Corneal Inlay

The KAMRA corneal inlay is an implant that was designed to help reduce the need for reading glasses. Dr. Peter Hersh was a principal investigator and the CLEI team participated in the clinical trials leading to the recent FDA approval.

You can watch a video interview with one of our Corneal Inlay clinical trial patients here –

In some patients with keratoconus, it might be helpful to decrease the unwanted optical side effects of light glare, halos, and double vision.

Smaller than a contact lens, the KAMRA corneal inlay looks like a black ring. There is a tiny aperture or hole in the center of the inlay. The inlay may help to improve vision in two ways

  1. Creates a pinhole effect so the scattered “static” light rays of keratoconus are blocked.
  2. Focuses light rays so you can see a wider range of vision near, intermediate (computer), and distance.

How does the KAMRA Inlay Work?

The KAMRA inlay sits in the first few layers of the eye known as the cornea. Smaller and thinner than a contact lens, the inlay is a mini-ring with an opening – or pinhole – in the center. This pinhole allows only focused light to enter your eye.

What can I expect during the KAMRA procedure?

The KAMRA inlay is an out-patient procedure performed at The Cornea and Laser Eye Institute by our doctors. From start to finish, the KAMRA inlay procedure will typically take around 30 minutes. Numbing drops are used to ensure you are comfortable throughout the procedure.

You may feel slight pressure while our doctors uses a laser to create a small opening the first few layers of your eye, known as the cornea. This is the same type of laser that is used to start a LASIK procedure.

The inlay is placed within the opening created by the laser. Once the numbing drops wear off, your eyes may feel irritated or scratchy and you may also experience tearing or light sensitivity.

Our doctors and staff will provide instructions on post-operative care on the day of treatment, including eye drops to use afterward. You will not be able to drive home after your procedure, so arrangements should be made beforehand for a ride. You should not drive until your doctor tells you that this is okay.

What is the recovery process?

As with any eye procedure, healing is a process. Adhering to your doctor’s recovery instructions will accelerate your progress. It is important to remember that the amount and pace of near vision improvement vary by individual.

While some patients see an improvement within the first week to a month, others may require additional time to heal. Most patients resume normal activities and return to work within 24-48 hours.

How can I find out if the KAMRA reading procedure is right for me?

If you are interested in learning if the KAMRA corneal inlay can reduce your dependence on reading glasses, contact the Cornea and Laser Eye Institute at 201-692-9434 or e-mail to schedule a complimentary consultation.

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