Posterior capsule opacification (PCO)

Posterior capsule opacification (PCO) is a physiological postoperative consequence of an uneventful uncomplicated extracapsular cataract surgery. Capsular opacification is different from the intraoperative opacification that takes place in the intact lenses. It is known as a plaque that can either be in the anterior and/or posterior capsule.PCO referred to as 'secondary cataract' or 'after cataract', develops over the clear posterior capsule a few months to a few years after an uneventful cataract surgery. Figure 1 shows various forms of capsular opacification. PCO results from the growth and abnormal proliferation of lens epithelial cells (LECs) on the capsule at the time of cataract surgery. 

Central PCO obscuring the visual axis can be treated with either surgical intervention, such as posterior capsule scraping or with a nonsurgical Nd:YAG laser capsulotomy. 

Ferrara Rings

The Ferrara Ring is a minimally invasive surgical option designed to correct ectatic corneal diseases in order to reduce the corneal steepening, reduce the irregular astigmatism and improve the visual acuity. The Ferrara ring is a surgical alternative to at least delay, if not eliminate, the need of lamellar or penetrating keratoplasty.

There are very few risks. As with any other surgery, there may be an infection. In this case, the ring shall be removed. There is no risk of rejection from the body. The surgery does not damage or prevent a cornea transplant. The complications are minimal and, most important, reversible. This means the ring can be removed and the cornea recovers its original size.

Amniotic membrane

Amniotic membrane transplantation is used in conjunction with surgical procedures involving the cornea, conjunctiva and limbus. It is also used to support local tissues in glaucoma bleb surgery, strabismus surgery and orbital reconstruction.

Amnion can be used as a graft material or bandage contact lens to promote healing and minimize inflammation, as a scaffold to cultivate stem cells, or as a structural reinforcement material. 

Corneal indications include persistent epithelial defect, recurrent epithelial erosion, corneal ulcer and perforation, inflammatory and infectious keratitis, bullous and band keratopathy, limbal stem cell deficiency, high-risk corneal graft, chemical injury, Stevens-Johnson syndrome and abnormal scarring after superficial keratectomy.

Penetrating Keratoplasty

Penetrating Keratoplasty (PK)

If the entire thickness of the cornea is unhealthy, a full thickness corneal transplant may be required.  This is called a penetrating keratoplasty (PK).  Where the DSAEK procedure is focused on transplanting only the endothelial cell layer of tissue, during a PK procedure a perfectly round circle of cornea is removed from the patient and replaced with donor tissue.  This new cornea is sutured into place with a stitch that is thinner than a human hair, for a comfortable healing process. 

DSAEK - Endothelial Transplant

Descemet's Stripping Automated Endothelial Keratoplasty (DSAEK)

A very common cause of a cloudy cornea is a damaged inside, or endothelial, layer of the cornea.  The endothelial layer is one cell layer thick and can be damaged by surgery or trauma or the cells can die too quickly over time (a condition known as Fuchs' Dystrophy).  When there are not enough endothelial cells, water can build in the cornea causing cloudy vision and vision loss.  DSAEK is a highly refined technique that replaces just the endothelial layer of the cornea, allowing surgeons to target the specific cause of the patient’s vision loss.  In the DSAEK procedure the damaged cells are stripped from the patient’s eye and replaced with a very thin back portion of a donor cornea.  This procedure allows your surgeon to literally replace only the damaged area of cornea, allowing a more precise treatment and better overall results.  Your surgeon uses an air bubble technique to hold the new tissue in place in the eye for the entire day of surgery so that no sutures are needed.