There are certain eye conditions that are often treated surgically. Go through this article for a brief overview about such surgical procedures.
Eye surgery or ocular surgery is a surgical procedure that is done on the eye or its accessory structures like the orbit, eyelids, eyebrows, and lacrimal apparatus. Usually, such surgeries are done by ophthalmologists for treating eye problems that cannot be relieved with medication. Refractive eye surgeries are very common, and are done for correcting errors like nearsightedness (myopia), farsightedness (hyperopia), astigmatism, etc. Generally, such surgeries are done using lasers.
Usually, local anesthesia is administered in eye surgeries, but in some cases, topical anesthesia is preferred. However, general anesthesia is preferred for kids and elderly, and for those with major eye problems or injuries. There are different types of eye surgeries that include cosmetic as well as vision-saving procedures. While some are optional, others are unavoidable.
Surgical Procedures for Eye Conditions
Cataract is an eye condition that is often described as cloudiness of the lens. So, a cataract surgery is performed when the natural lens of the eyes turn opaque; due to old age, disease, or any kind of trauma. As a result, the image formed on the retina will be hazy and blurred. Such cases warrant cataract operation, in which the defective lens is removed, and is replaced with a man-made intraocular lens. A cataract surgery takes around 30 to 45 minutes, and is usually done under local anesthesia.
Usually, cataract surgeries involve a procedure called phacoemulsification (phaco). In this procedure, a small incision is made to insert a probe, which dissolves the cloudy lens using ultrasonic vibrations. Extracapsular cataract extraction (ECCE) is another procedure that involves removal of the entire natural lens through a large incision. The lens capsule is retained for placing the intraocular lens. Intracapsular cataract extraction (ICCE) is a highly complicated procedure that involves removal of the lens capsule, along with the natural lens.
Glaucoma is a medical condition, wherein a raised intraocular pressure, due to excess of aqueous humor, affects the functioning of the optic nerve, leading to a loss of vision. Oral and topical medicines may prove effective for controlling the condition during the initial stages. Surgery becomes unavoidable, if the condition gets severe. Cataract surgery is of different types. The severity of the disease and the health condition of the eye, are among the major factors that are considered by the doctor, while recommending a specific type of cataract surgery.
Laser trabeculoplasty is a procedure that creates tiny holes using a focused beam of light, to drain the aqueous humor. While a new procedure called Selective Laser Trabeculoplasty (SLT) is recommended for those in the initial stages of glaucoma, a conventional surgery termed trabeculectomy is preferred for those in the advanced stages. The latter procedure involves removal of tissues from the eyes’ drainage system. Trabeculotomy is a type of cataract surgery, wherein eye tissues are not removed. Goniotomy is a cataract surgery that is performed in kids. Newer and minimally invasive procedures include deep sclerectomy and viscocanalostomy. Iridotomy is a procedure that is recommended for those with angle-closure glaucoma. It involves making small openings through the iris. Iridectomy involves removal of a part of the iris tissue.
Refractive Eye Surgeries
These eye surgeries are done for correcting refractive errors like myopia and hyperopia, so that use of corrective lens can be eliminated. These procedures involve reshaping the cornea, and lasers are commonly used for this purpose. The most common refractive eye surgeries are LASIK (Laser-Assisted In Situ Keratomileusis) and PRK (Photorefractive Keratectomy).
- LASIK is used for treating myopia (shortsightedness), hypermetropia (longsightedness) and astigmatism (inability of the eye to focus on a point object due to irregular curvature of the cornea or lens); and it involves removal of corneal tissue and reshaping of the cornea. It may cause side effects like dry eyes.
- PRK is a surgical procedure, in which an excimer laser is used to remove a small part of the corneal stroma from the anterior part of the eye. This procedure is preferred for those with thin corneas. Laser Assisted Sub-Epithelium Keratomileusis (LASEK) is a surgical procedure that is similar to PRK.
- Laser Thermal Keratoplasty (LTK) is used for correcting presbyopia, and to improve vision that tends to deteriorate after the age of 40. Mini Asymmetric Radial Keratotomy (M.A.R.K.) is done for correcting astigmatism, and to cure keratoconus (cornea becomes thin and conical) in the initial stages.
- Other types of refractive surgeries include laser photocoagulation, laser reversal of presbyopia, Conductive Keratoplasty (CK), Radial Keratotomy (RK), Hexagonal Keratotomy (HK), Scleral reinforcement surgery, Anterior Ciliary Sclerotomy (ACS), etc.
Refractive eye surgeries comprise a majority of the surgical procedures performed on the cornea. Another procedure that can be listed under this category is corneal transplant surgery, in which a diseased or cloudy cornea is replaced with a healthy donor cornea. Such transplantation is usually done when the cornea becomes cloudy and opaque. Corneal endothelial dystrophy, bacterial and viral infections of the cornea, and persistent corneal swelling after cataract surgery, are some medical conditions that may require corneal transplantation. Osteo-odonto-keratoprosthesis (OOKP) is a new technology in this field. In this method, an artificial cornea is regenerated from a tooth (of the patient), and is used to replace the damaged cornea. This procedure is still being fine tuned and is yet not practiced fully.
Eye Muscle Surgeries
This type of surgery corrects conditions wherein the eyes are not normally aligned with each other, due to problems in the eye muscles. The small extraocular muscles control the movements of the eye ball. Strabismus is the most common eye condition that is corrected by repairing eye muscles. Conditions like nystagmus and Duane syndrome may also require such surgeries. These surgeries involve weakening, tightening, or repositioning of the eye muscles, according to the underlying medical condition.
Orbital and Oculoplastic Surgeries
Orbit is the bony socket inside which the eye and its accessory structures are located. Sometimes, problems in the eye socket may affect the normal functioning of the eye. Orbital and oculoplastic surgeries are done for correcting problems involving the eyelids, the lacrimal (tear) system, the socket, and the orbit.
- Oculoplastic surgeries include blepharoplasty, in which the upper or lower eyelid is reshaped, either by removal of subcutaneous fat or excess skin. This procedure is often done in cases of idiopathic swollen eyelids. The desired result can also be achieved by reinforcing the surrounding muscles and tendons. It is also called eyelid lift surgery.
- Otherwise known as forehead lift or browlift, browplasty is a cosmetic surgical procedure which is done in those with low and drooping eyebrows that can obstruct vision. The surgery is also performed for removing ‘worry’ lines from the forehead.
- Canthal surgeries like canthoplasty and canthotomy are done on any one or both corners of the eye. Canthectomy refers to a surgery that involves removal of tissues from the canthus. In canthotomy, the canthus is cut to reduce excess orbital pressure.
- Oculoplastic surgeries include surgical repair of the eyelids, for conditions like ectropion and entropion.
- Ocular prosthesis is a surgical procedure in which a damaged eye is removed and a prosthetic eye is implanted. Evisceration and enucleation are two methods that are used for removing the damaged eye.
Removal of orbital tumors, orbital reconstruction, correction of excessive tearing, etc., come under this category. In some cases, the entire eye is removed (enucleation) from the socket. This surgical procedure is done in severe cases of retinoblastoma (a rare cancer of the eye which is seen in children), last stages of glaucoma, severe inflammation of the eye (ophthalmia), and congenital cystic eye. Blepharospasm (excessive blinking) is often treated with Botox surgeries. Eyebrow tattooing can also be considered as a cosmetic eye surgery, which is becoming increasingly common. These procedures are easy to perform, requires less time, and the person can resume doing his normal daily activities in no time!
Proper eye care is very important after an eye surgery, to ensure speedy recovery and complete healing. So get those beautiful eyes treated, because after all, beauty lies in the ‘eyes’ of the beholder!
Disclaimer: This article is for informational purposes only, and should not be used as a replacement for expert medical advice. Visiting your physician is the safest way to diagnose and treat any health condition.