Medical advancement may have progressed in leaps and bounds but can eye drops alone replace surgical procedures? The answer is no, at least for now for some and probably not for other especially anytime near future. Here are some of the common eye surgeries performed by ophthalmologists to treat, improve and prevent vision loss and blindness.
Cataract is one of the eye surgeries which I find more satisfying to perform. The reason being is that cataract surgery can restore back the vision lost, with high success rate and minimal complication. Cataract is the condition where the natural lens in the eye turns cloudy and blurs the vision. It may present itself like a white curtain or like looking through a frosty or fogged-up window. The most common cause for cataract to occur is ageing and its normal progression is very gradual.
Nope, eye drops or oral supplements can’t cure cataract either. Typically, you would need to undergo a surgery. Fortunately, cataract surgery is generally a safe and effective procedure. Natural lens in the eye which has turned cloudy will be removed and replaced with an artificial lens. There are some options when come to the types of lenses; I’ll normally explain the difference and allow my patients to decide on one which suits their lifestyle better.
Corrective eye surgery
Corrective eye surgery refers to surgeries done to correct refractive errors such as astigmatism, near-sightedness (myopia) and farsightedness (hyperopia). These procedures or surgeries are performed to either remove or reduce the reliance on glasses or lenses. It may be for aesthetic purpose, convenience or even for performance especially when taking athletes into consideration.
Common types of corrective eye surgeries to treat astigmatism, near-sightedness, or far-sightedness are as follow:
Implantable Contact Lens (ICL) surgery is recommended for people who are not able to undergo a laser refractive vision correction due to high refractive power or the corneal thickness.
Note: ICL is not the same as IOL. Intraocular Lens (IOL) implants are used for implantation after removal of the cataractous lens in cataract surgery.
Laser-assisted in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) are laser procedure done by reshaping the cornea. Laser-assisted subepithelial keratomileusis (LASEK) in the other hand combines the benefits of both LASIK & PRK.
Small Incision Lenticule Extraction (SMILE), as the name suggests, is a surgery where the surgeon creates and removes a small, lens-shaped bit of tissue (lenticule) within the cornea.
Glaucoma surgery
As I would always say, glaucoma is a silent vision thief! It is the leading cause of blindness in the population above the age of 60. Glaucoma occurs when intraocular pressure (pressure in the eye) is persistently higher than in a normal eye. The elevated pressure in the eye causes damage to the optic nerve. Vision loss due to glaucoma is usually permanent. The eye drops given are to prevent further damage to the eye. These medications typically work by reducing the pressure in the eye to prevent further damage to the optic nerve.
When medications do not work, glaucoma eye surgery can be considered. The relevance behind the procedure is to relieve the pressure in the eye by slightly increasing the flow fluid from the eye or by lowering the fluid production. The following procedures can be considered if you have an open-angle glaucoma:
Trabeculoplasty. This opens the drainage area
Iridotomy. This makes a tiny hole in your iris to let fluid flow more freely.
Cyclophotocoagulation. This treats areas your eye to lower fluid production.
Trabeculectomy, a microsurgery where surgeon opens a new channel to drain the fluid and reduce eye pressure.
A combinations of eye drops, laser trabeculoplasty, and microsurgery are most often done to treat open-angle glaucoma. Meanwhile, acute angle-closure glaucoma is usually treated with a laser procedure
Corneal surgery
Cornea is the outermost area of the eye which helps to focus the light. Sometimes when the corneas are damaged or diseased beyond repair it would need to be replaced with a donor’s cornea. This surgical procedure is called the corneal transplant. The procedure will be referred to as keratoprosthesis when an artificial cornea is used instead of a traditional corneal transplant. This may be done when a tradition corneal transplant is not successful.
A more common corneal surgery would be Pterygium excision. It is an eye surgery to remove a wing-like membrane that grows from the conjunctiva onto the cornea called pterygium. This procedure is required to prevent complications such as blepharitis, distorted vision, and eventual vision loss.
Retinal surgery
The retina consists of layers of tissues located at the rear segment of the eye. It contains the light sensitive cells which will translate light into electrical signal which then sent to the brain via the optic nerve for processing and interpretation. Conditions which affect the retina will directly lead to poor quality of vision, visual field loss and even blindness. Some of the common retinal diseases include diabetic retinopathy, age-related macular degeneration, retinal tear, retinal hole and retinal detachment. Treatment of retinal diseases often revolves around restoring retina’s function by improving and maintaining its structure. This may consist injection procedures, laser photocoagulation, cryotherapy or even surgeries to get rid of fluid accumulation, repair holes and tears and securing it back to its supportive tissue to prevent further degeneration or detachment. Examples of retinal surgeries are:
Pneumatic retinopexy
Scleral buckle.
Vitrectomy.
Oculoplastic surgery
Oculoplastic surgeries are normally performed to correct various abnormalities around the face especially the eye and eyelids. The procedures can be for aesthetics purposes or to address issues which may affect the eyes and vision. Oculoplastic surgery entails eyelid repair when the eyelids are droopy or doesn’t close properly, tumor excision, repair or reconstruction of tear duct and fractured orbital. Meanwhile, oculoplastic surgeon can perform facial rejuvenation procedures such as brow lift, eye lifts, excision of xanthelasma and skin resurfacing.