Corneal Transplant Procedure

The cornea is the clear front window of the eye that pushes light to the interior of the eye. This is what makes us see clearly. Light is refracted through the cornea, a curved surface, onto the retina, making a clear image.

Clouding of the cornea blocks the clear passage of light to the back of the eye and can reduce vision drastically, even to blindness. Clouding can occur due to corneal injury, corneal disease, hereditary conditions. Along with clouding corneal injury and disease can be extremely painful.

The only way to restore sight to a clouded cornea is to replace or transplant the cornea itself. Corneal transplantation, also known as keratoplasty, is the most successful of all tissue replants. The rate of success is dependant on the cause of the clouding. Transplants for degeneration after cataract surgery for keratoconus have a high success rate where as transplants for chemical burns have lower success rates.

What is the procedure for a corneal transplant?

The eye bank provides corneal tissue necessary for the transplant, from a donor. Patients are placed on a waiting list until the tissue is available. The operation transfers the clear central part of the cornea from the donor’s eye to the patient’s eye. The sooner the donor cornea is used, the more successful the results of the transplant will be. When a cornea becomes available, the patient is contacted and the surgery will normally take place with 24 hours.

What happens after the procedure?

The day after surgery the patch put over the eye during surgery is removed. From this time on, sunglasses will be necessary to prevent too much glare into the eyes. You will also need to wear a small plastic shield at night to protect your eye while sleeping. For around 2 weeks after surgery, your eye will most likely be red and watery.

Post-Operation?

Regular check-ups are necessary after surgery. Post-operative visits are normally scheduled for one week, one month, and then approximately every three months after surgery. You will need to be drops in your eyes after the surgery and usage instructions will be given on a case to case situation.

Are there any risks?

All surgeries risk the possibility of infection and haemorrhage. With ocular microsurgery, these risks are very rare. Additionally, there is a risk of rejection from the donor cornea. If this does happen, the eye may become red or painful and your vision will deteriorate. If this happens or you show any symptoms after surgery, you must seek help as quickly as possible so that your doctor can successfully fix the problem.

Do the sutures need to be removed after surgery?

Sutures do need to be removed after surgery. This is done in the office after a drop of local anaesthetic. The time for suture removal will vary depending on the eye disease, but is never before six months, and will sometimes be longer than twelve months. You will not feel the sutures as they are buried in the eye.

How quickly will my vision recover?

Vision recovery is dependant on the reason for the surgery. The cornea will have a stable shape within 8 weeks, but complete vision is not usually achieved until the sutures are removed.

What is Monovision

Monovision is the use of one eye for distance vision and the other eye for near vision reading. Usually your dominant eye is clear for distance, and the non-dominant eye is purposely left a little short-sighted so that you can read most things without glasses. This provides freedom from your reading glasses, although occasionally they may still be required for long periods of detailed close work.

Is Monovision Right for You?

If you are over 45 years of age and are starting to notice some problems with your reading vision, or if you already have reading glasses and find them less than satisfactory for your life-style, you could benefit from monovision. A good way to determine if monovision is right for you is to “test drive” the effect by wearing a pair of very thin and comfortable contact lenses for a few hours. We provide this service as part of our assessment for Laser Surgery, and have contact lenses to suit most eyes in stock here for this purpose.

What are the Benefits of Monovision?

The main advantage is freedom from your reading glasses. This can be particularly useful for people who need to see at a wide range of distances in their daily activities. People who are always on the move, with a combination of activities such as meetings, presentations, etc. find monovision particularly useful.

Are there any Disadvantages?

Like all other good things, there is the occasional drawback. Some people are not ideally suited to monovision. This is often difficult to predict, so we usually simulate or “test-drive” the vision with a contact lens or spectacle lens so that you can experience it before you decide to have surgery. Some people notice slightly decreased depth perception, and this may make some activities more difficult, for example, when driving at night. Wearing a small prescription of glasses for driving can be helpful in these cases.

How is Monovision Achieved?

This type of vision is achieved by correcting the dominant eye for distance, and the non-dominant eye for close work. This can be achieved with contact lenses or, for the ultimate convenience, surgery. Often, only one eye will require surgery. Monovision can be achieved by a number of surgical options including Laser Surgery. These options will be fully discussed with you at your assessment, and the surgeon will recommend the procedure that will give you the best visual outcome.

Vision Eye Surgery Side effects

How successful is Laser Eye Surgery?

Nevertheless, people interested in having the laser eye surgery need to keep in mind that it is not possible to exactly predict the level of vision that will occur after surgery. This is because, like any surgery, the healing characteristics of your eyes are not the same as another persons. However, based on the clinical measurements obtained at the initial consultation, your surgeon will be able to indicate the expected result.

Experience has shown that, after LASIK treatment, the vast majority of people with low to moderate short-sightedness (myopia) achieve 20/40 vision or better, which is the level required to pass the vision test for obtaining a driver’s licence in most States. Many people can and do achieve 20/20 vision. However, even if 20/20 is not achieved, most people find that laser eye surgery has improved their vision to an extent that they are able to perform daily activities without glasses or contact lenses, and they enjoy significant freedom from having improved their vision.

Occasionally, the outcome may not meet all expectations. In some instances, a follow-up procedure, called an enhancement, can help to achieve more precise vision correction. If you are not happy with your outcome, you should talk to your surgeon because there is often something that can be done to improve the situation.

At Vision Laser, the vast majority of people are very satisfied with their results and the freedom it provides. In fact they often tell us – “I wish I had this done years ago”.

Laser Eye surgery, Risks

What are the Risks of Laser Eye Surgery?

Laser eye surgery with an Excimer laser was first performed on humans in 1987. Since that time, it is estimated that over 16 million people around the world have had laser eye surgery. Medical research has demonstrated that laser eye surgery is a very safe and effective procedure. However, as with any type of surgery, complications can occur. Most of these potential complications either resolve by themselves or are treatable.

What is the Chance of Developing a Severe Complication?

Serious complications are very infrequent, and the risk of blindness or significant loss of vision from LASIK is extremely small. Some complications can delay full recovery of the eyes for several weeks or months, but it is highly unlikely they will result in serious or permanent loss of vision. At Vision Laser there has never been an incidence of blindness as a result of laser eye surgery. Less than 1% of patients experience serious problems that have the potential to significantly harm the vision.

What Side-Effects and Complications Can Occur?

Use the table below to find out about certain complications that can occur, and how they can be treated. This list is intended as a guide only and is not intended to be a complete list. Fortunately, most side effects and complications resolve within three months of surgery and they do not result in long-term vision problems.

It may be possible to have laser eye surgery again (called an enhancement), but not in all cases.

Intralase Lasik Surgery

If you have decided to go ahead and have laser eye surgery then you are very likely to have been offered a choice of getting Intralase. Intralase may be the latest development in laser eye surgery and is a type of Lasik and is normally termed Intralase Lasik. Intralase Lasik some say is the gold standard in laser eye surgery and this could be because of the various benefits it offers over common Lasik. Intralase is different to standard Lasik in the way in which the flap is formed. In the course of normal Lasik the flap (outer layer of cornea) is established using a microkeratome (surgical blade) whereas with Intralase it is created using a laser. The creation of the flap is necessary so that the operating doctor can access the inner layers of your cornea which are to be lasered during the particular treatment. Intralase is so termed as a bladeless procedure and is becoming increasing popular. Let’s consider its benefits and find out if it is well worth the additional cost:

Identified Risks/complications: Generally there are fewer complications when in comparison with standard Lasik as the flap that is designed is much more precise and cleaner. The vast majority of complications with Lasik will be flap related.

Dry Eyes: There is less of a chance of acquiring dry eyes if you have Intralase.

Recovery Time: Recovery time is normally faster than compared with standard Lasik and eyesight stabilises far sooner as well.

Results: Having Intralase gives people a greater platform of achieving 20:20 vision following surgery. This not exclusively improves the quantity of your vision (how far you can see down the test chart) but it also improves the quality of your vision, meaning you are less likely to have night vision difficulties following surgery.

The previously mentioned information is meant for informational purpose only, please contact vision eye institute in the event that you have any kind of concerns concerning your own vision. Information and facts offered were not necessarily constructed by dr and is created simply to distribute knowlegde concerning Intrase LASIK

Lasik

The IntraLase laser uses the latest technology for creating the corneal flap required for LASIK.
The IntraLase laser uses a rapidly fired, very short duration (femtoseconds) pulse of energy with a tiny spot size. This creates minimal disruption to adjacent

Laser Eye Surgery Intro

Laser Eye Surgery – An introduction

Laser vision correction, or laser eye surgery, is a surgical treatment for people who want to reduce their dependence on glasses or contact lenses. If you are dissatisfied wearing glasses or contact lenses, then laser vision correction could be for you.

The revolutionary procedure known as LASIK has become one of the most popular and successful in the world today.

And now it is even better, thanks to the introduction of the IntraLase method, the 100% blade-free procedure that is especially suited to people who have previously been afraid to have anything done to their eyes!

Read on to learn more about the remakable advances in technology, and about what is involved in having laser vision correction.

Wavefront-guided laser

Wavefront-guided laser vision treatment

Wavefront-guided laser vision treatment is one of the latest developments in Laser Eye Surgery, vision correction. It simply means that the laser treatment that re-shapes the cornea takes into account small optical imperfections that are present in the Human eye. The main benefit of wavefront-guided treatment, compared to traditional laser corrective treatment, is that a better quality of vision can be achieved.

The optical principle behind this type of correction is called wavefront technology, which is a technology that was originally developed in the field of astronomy in order to reduce the optical aberrations (imperfections) in telescopes.

The wavefront-guided correction systems used at Vision Laser have three main parts:

1. Wavefront aberrometer – the instrument for measuring the optical imperfections of the eye before surgery.
2. Active eye-tracker – the laser’s eye-tracker that tracks the eye’s position at an extremely high rate in order to ensure that even the small involuntary movements of the eyeball are compensated for during surgery. Without this capability, wavefront-guided treatment would not be possible.
3. Wavefront correction – the actual laser treatment given to the cornea during surgery, which takes into account the small optical imperfections.

Wavefront-guided laser correction is considered to be the most advanced method of laser vision correction. The systems we use have received clinical approval from the highly respected Food and Drug Administration in the USA. The Vision Eye Institute clinics were the first in Australia to utilise this revolutionary technology.

Wavefront-guided laser treatment is possible for most people, but not everyone, it depends on the prescription. At Vision Eye Institute it does not cost more than traditional laser treatment. After your laser assessment consultation has been completed the doctor will be able to advise you if your eyes can benefit from wavefront-guided laser treatment.

Intraocular Pressure

PRK and LASEK

PRK (PhotoRefractive Keratectomy)

PRK is the first type of laser Eye surgery to have been developed. It started in 1987, but became less frequently used by the mid-1990′s as LASIK evolved. Later, a modified PRK technique, called LASEK, was developed, and this was further refined into the ASLA technique in use today.

Unlike LASIK, no corneal flap is created in the PRK procedure.  Instead, PRK involves removing the top layer of the cornea (the epithelium) so that the laser beam can access and re-shape the cornea below the surface.
Description of the procedure

The PRK procedure takes about 15 minutes per eye:

• The cornea is anaesthetised.
• Anaesthetic drops are applied to the eye, and an eyelid holder is put in place to keep the eye from blinking.
• The corneal epithelium layer is removed.
• The surgeon removes the top layer of the cornea (the epithelium) in order to gain access to the corneal bed below the surface.  The top layer will regenerate naturally within a few days.  Unlike LASIK, no corneal flap is created in the PRK procedure.
• The corneal bed is re-shaped by the laser.
• Pulses of laser energy are then applied to re-shape the corneal bed specifically to the prescription of the eye.  The laser uses a cool ultraviolet light beam to precisely ablate, or vapourise, a pre-determined amount of corneal tissue.
• A soft contact lens is applied.
• The eye is fitted with a “band-aid” soft contact lens for protection while the top layer of the cornea regenerates over the next few days.  (Sometimes an eye-pad is used instead of a contact lens).
• Antibiotic and anti-inflammatory eye drops are applied.
• Because the recovery of the eye was relatively slow with PRK, it gave way to the LASIK technique.
• Both eyes are not usually treated on the same day.

Post-op Visual Recovery

Vision is blurry for about a week after surgery. Also, because the 2 eyes are not usually treated on the same day, it takes longer for patients to resume normal activities.
Post-op Comfort

The eyes can feel uncomfortable or painful for about 2 days.
Post-op Stabilisation of Prescription

Stabilisation may take 3 months. Significant regression can occur, particularly with high prescriptions.
Post-op Corneal Haze

Some corneal haze is present for a few months.

LASEK (Laser Epithelial Keratomileusis)

LASEK is a type of laser vision surgery for the correction of refractive errors such as short-sightedness (myopia) and astigmatism.

LASEK was developed for use in cases where LASIK was considered unsuitable because the thickness or topography of the cornea was not adequate.

Both the LASEK and LASIK procedures involve creation of a corneal flap, followed by re-shaping of the cornea.  In LASEK, only the topmost (epithelial) layer of the cornea is used for the flap. In contrast, the LASIK procedure the flap is thicker.
Description of the procedure

The LASEK procedure takes about 15 minutes per eye:

• The cornea is anaesthetised.
• Anaesthetic drops are applied to the eye, and an eyelid holder is put in place to keep the eye from blinking.
• The corneal epithelium layer is removed.
• Eye Drops are applied to the corneal surface to help separate the epithelium layer from the corneal bed. The surgeon gently moves the top layer, or epithelium flap, to one side, thereby exposing the corneal bed.
• The corneal bed is re-shaped by the laser.
• The surgeon uses the laser to re-shape the corneal tissue immediately below the topmost layer (epithelium) of the cornea.  (This contrasts with the LASIK procedure in which deeper layers of corneal tissue are penetrated.)  The laser uses a cool ultraviolet light beam to precisely ablate, or vapourise, a pre-determined amount of corneal tissue for the required prescription of the eye.
• The  corneal epithelium is placed back over the cornea.
• The surgeon re-positions the epithelium layer to cover the corneal bed that was lasered.  A “band-aid” soft contact lens is applied to protect the eye while it is healing over the next few days.  Antibiotic and anti-inflammatory drops are also applied.
• Both eyes can usually be treated on the same day.

Post-op Visual Recovery 

Vision is blurry for about a week after surgery, but both eyes can be treated on the same day.
Post-op Comfort

The eyes can feel uncomfortable or painful for about 2 days.
Post-op Stabilisation of Prescription

Stabilisation takes about 2 months.
Post-op Corneal Haze

Some corneal haze is present for a few months but it does not usually affect the vision.