Eye surgery encompasses various medical procedures performed on the eye or its surrounding structures, typically by an ophthalmologist. These procedures aim to treat diseases, injuries, or conditions that affect vision or the overall health of the eye. Modern eye surgery uses high precision and advanced techniques, often utilizing microscopic instruments and sophisticated laser technology. The field continually evolves, offering solutions for a wide range of ocular issues, from correcting common vision impairments to addressing complex diseases.
Refractive Surgeries
Refractive surgeries correct common vision problems like nearsightedness (myopia), farsightedness (hyperopia), and astigmatism. These procedures reshape the cornea or implant an artificial lens to alter the eye’s focusing power, ensuring light focuses on the retina for clearer vision.
LASIK (Laser-Assisted In Situ Keratomileusis) is a widely known procedure. A surgeon creates a thin, hinged flap on the cornea’s surface, lifts it, and an excimer laser reshapes the underlying corneal tissue. The flap is then repositioned for healing.
Photorefractive Keratectomy (PRK) reshapes the cornea directly on its surface. Unlike LASIK, PRK does not involve a corneal flap; the outermost layer (epithelium) is removed before the excimer laser is applied. The epithelium regrows over several days. PRK may be preferred for individuals with thinner corneas or those with a higher risk of eye injury.
Small Incision Lenticule Extraction (SMILE) is a less invasive laser procedure. A femtosecond laser creates a small, lens-shaped tissue piece (lenticule) within the cornea. The surgeon removes this lenticule through a tiny incision, altering the cornea’s shape and correcting vision. Implantable Collamer Lenses (ICL) involve surgically implanting a thin, flexible lens inside the eye, typically between the iris and the natural lens. This option is suitable for individuals with high refractive errors or those not ideal for laser vision correction.
Cataract and Glaucoma Surgeries
Cataract and glaucoma surgeries address two prevalent age-related eye conditions that can impair vision. Cataracts involve the clouding of the eye’s natural lens, leading to blurred vision, faded colors, and increased glare sensitivity. Surgical removal is the most common treatment.
Cataract surgery typically involves phacoemulsification, where a small incision is made in the cornea. An ultrasonic probe breaks up the cloudy lens into fragments, which are suctioned out. A clear artificial intraocular lens (IOL) is then implanted to restore focus and clear vision. This outpatient procedure often leads to significant vision improvement.
Glaucoma is a condition associated with elevated intraocular pressure that can damage the optic nerve, potentially leading to vision loss. Surgical interventions for glaucoma aim to reduce this pressure by improving fluid drainage. Trabeculectomy creates a new drainage pathway in the sclera to allow fluid to flow out and reduce pressure.
Another approach involves drainage devices or shunts, tiny tubes that redirect fluid from inside the eye to an external reservoir, easing pressure. Minimally Invasive Glaucoma Surgeries (MIGS) use tiny incisions and microscopic equipment. MIGS procedures, such as iStent or XEN gel implant, often bypass blockages or create new, small pathways to improve fluid outflow, with less recovery time than traditional surgeries.
Retinal and Vitreous Surgeries
Retinal and vitreous surgeries address conditions affecting the retina and vitreous humor at the back of the eye. The retina is the light-sensitive tissue lining the back of the eye, converting light into electrical signals. The vitreous humor is a clear, gel-like substance filling the space between the lens and the retina. These surgeries are important for preserving vision when these structures are compromised.
Vitrectomy is a common technique where the surgeon removes some or all of the vitreous humor. This allows direct access to the retina for necessary repairs. The vitreous is then typically replaced with a clear fluid, gas bubble, or silicone oil to help hold the retina in its proper position during healing.
Conditions treated include retinal detachment, where the retina pulls away from its normal position. During surgery, the vitreous is removed, and the retina is reattached using methods like laser photocoagulation or cryopexy to seal tears, and the injection of gas or oil. A macular hole, a small break in the macula (the central part of the retina responsible for sharp, detailed vision), is also treated. Vitrectomy allows for the removal of scar tissue pulling on the macula, facilitating the closure of the hole.
Diabetic retinopathy, a complication of diabetes that damages retinal blood vessels, can also necessitate these surgeries. This condition may lead to bleeding into the vitreous or the formation of scar tissue that pulls on the retina, causing vision loss. Vitrectomy helps by removing blood and scar tissue from the vitreous, relieving traction on the retina and improving visual clarity.
Corneal and Oculoplastic Surgeries
Corneal and oculoplastic surgeries address distinct parts of the eye and its surrounding structures. Corneal surgeries focus on the cornea, the clear, dome-shaped front surface that plays a crucial role in focusing light. Oculoplastic surgeries involve the eyelids, tear ducts, and the orbit (the bony socket surrounding the eye).
Corneal transplants (keratoplasty) replace a damaged or diseased cornea with healthy donor tissue. This surgery is necessary when the cornea is scarred, distorted, or cloudy due to conditions such as keratoconus, Fuchs’ dystrophy, or severe infections, and vision cannot be adequately corrected with glasses or contact lenses. Depending on the extent of damage, the entire cornea (penetrating keratoplasty) or specific layers (lamellar keratoplasty) may be replaced.
Oculoplastic surgeries correct structural or functional issues around the eye. They address eyelid malpositions like entropion (eyelid turns inward) or ectropion (eyelid turns outward), which can cause irritation and affect eye health. Surgical correction helps restore the eyelid to its proper position, protecting the eye.
Tear duct blockages, which can cause excessive tearing and recurrent infections, are treated through oculoplastic procedures such as dacryocystorhinostomy (DCR). This surgery creates a new pathway for tears to drain from the eye into the nasal cavity, bypassing the obstruction. Other oculoplastic interventions include orbital tumor removal and cosmetic eyelid surgery (blepharoplasty), which reshapes the eyelids for aesthetic or functional improvement.