Among the most common complications after inflammation or damage to the cornea are corneal ruptures and scarring, which, if left untreated, can result in the need for a transplant. However, modern ophthalmology has less invasive methods of treating and removing corneal scars and corneal cracks, including spontaneous recurrent corneal surface cracking (“recurrent erosion”).
If keratitis does not involve maceration, cracking, ulceration of the cornea, complications in the form of scarring usually do not appear. However, any ulcerative form of the disease always leaves scars on the cornea, which inevitably lead to deterioration of vision. Inflammatory infiltrates, opacities and scarring on the cornea reduce its transparency. A patch of white or gray color appears in the visual field, and the corneal surface becomes dull.
Although superficial corneal scars can also be treated mechanically, by scraping them off using, for example, a so-called “scrape”. Hockey knife, while recurrent corneal erosion can be attempted by first treating with ointment and pressure dressings or needle puncture; however, the aforementioned treatment methods are often less accurate than PTK and do not always lead to equivalent results.
With PTK (Photo Therapeutic Keratectomy), an excimer laser phototherapeutic keratectomy surgery, it is possible to remove corneal scars both centrally and peripherally located. Scars on the cornea cause light penetration into the eye to be impaired, similar to a dirty camera lens. Using a leser, corneal scars can be removed. In the case of small scars, the laser immediately removes small particles from the entire clouded area. For deeper and more extensive cases, the upper layer of the cornea (epithelium) can be removed first, in order to remove the actual opacified parts of the cornea as accurately as possible with the laser. Surgery
removal of scars
Corneal scarring thus often proceeds in two stages: in the first stage, a phototherapeutic keratectomy is performed, primarily to reduce the opacity. After some of the scar tissue is removed, the cornea will relax over the next few months. This reduces its irregular curvature, which is often treated a few months later with a second laser surgery, wavefront-guided PRK (photorefractive keratotomy).
With the excimer laser and special laser profile, the diseased tissue can usually be removed and the cornea gently “polished,” eliminating the need for a transplant.
Patients with deposits, opacities or cracks caused by laser corneal scar removal and “laser corneal polishing” are eligible for the procedure:
After the operation, a bandage is placed over the eye. Alternatively, a contact lens is used protectively. After surgery, very rarely, infectious keratitis or ulcers may develop under the contact lens applied as a dressing. Immediate follow-up and ophthalmic treatment is then necessary.
NOTE: light to moderate opacities in areas where the cornea was treated may appear ca. month after the operation, but they will gradually disappear over the course of four months and generally disappear completely after about two to three years.
