Corneal Surgery
Diseases of the cornea may require specific medical treatments (eye drops, contact lenses, local care) and, in some cases, corneal surgery: transplantation, intracorneal rings, cross-linking, etc.
A specialized assessment makes it possible to determine whether corneal surgery is indicated and which technique is best suited to your situation.
When should corneal surgery be considered?
Corneal surgery may be discussed in several situations:
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- Keratoconus or other corneal ectasias
- Corneal scars following infection, trauma, or burns
- Corneal dystrophies
- Chronic corneal edema
- Complications after eye surgery that have altered the cornea
The goal of corneal surgery is to restore a more regular and more transparent cornea in order to improve vision and visual comfort.
Corneal cross-linking
Corneal cross-linking is a technique aimed at strengthening the cornea, particularly in cases of keratoconus or other ectasias:
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- Application of vitamin B2 (riboflavin) to the cornea
- Controlled exposure to UV-A light to create additional cross-links within the corneal collagen
The objective is to stabilize the progression of corneal deformation, not to fully correct vision.
Cross-linking is often proposed for young patients when the cornea shows signs of progressive weakening.
Intracorneal rings
Intracorneal rings are small segments made of transparent material that are inserted into the thickness of the cornea.
They are mainly used in keratoconus or certain corneal irregularities. They help reshape the curvature of the cornea and reduce deformation.
Vision may be improved, sometimes in combination with glasses or contact lenses.
Intracorneal rings do not always replace corneal transplantation, but they can delay or avoid transplantation in some cases.
PTK (Phototherapeutic Keratectomy)
PTK is an excimer laser treatment used to manage certain corneal diseases or abnormalities. It has a therapeutic goal: to improve corneal transparency, reduce surface irregularities, and enhance visual comfort.
It is particularly indicated for the treatment of certain superficial corneal scars.
Depending on their location and depth, corneal scars may cause blurred vision, reduced contrast, glare, or persistent visual discomfort.
Procedure
PTK is performed on an outpatient basis under local anesthesia with eye drops. The procedure lasts a few minutes per eye.
The main steps include:
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- Removal of the superficial layer of the cornea
- Targeted excimer laser treatment of the affected area
- Placement of a temporary bandage contact lens
Eye drop treatment is prescribed after the procedure.
After PTK, it is common to experience:
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- Discomfort or moderate pain during the first few days
- Temporary blurred vision
- Gradual improvement in vision over the following weeks
Regular follow-up allows monitoring of healing and visual outcomes.
As with any procedure, there are rare risks: delayed healing, temporary dry eye, or partial visual improvement depending on the depth of the scar.
Corneal transplantation (keratoplasty)
When the cornea is too damaged or too opaque, a corneal transplant (keratoplasty) may be required. The transplanted cornea comes from a donor (corneal bank). The procedure is performed in the operating room under local or general anesthesia, depending on the case.
Penetrating keratoplasty: full-thickness transplant replacing the entire central area of the cornea
Lamellar keratoplasties (DALK, DSAEK, DMEK): partial transplants replacing only certain layers of the cornea (anterior or posterior)
When possible, lamellar transplants preserve part of the original cornea and reduce certain risks (rejection, fragility, etc.).
Postoperative course and visual recovery
Postoperative outcomes depend on the technique used, but commonly include:
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- Fluctuating vision for several weeks or months
- The need for prolonged eye drop treatment (anti-inflammatory and sometimes anti-rejection drops)
- Regular follow-up visits to monitor healing, graft transparency, and intraocular pressure
After a corneal transplant, final visual correction may require glasses or contact lenses, and sometimes additional procedures (laser treatment, suture adjustment).
Visual recovery after corneal surgery is often gradual and requires patience, but it can result in a significant improvement in visual quality.
Risks and possible complications
Like any eye surgery, corneal surgery carries rare potential risks such as:
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- Infection or significant inflammation
- Graft rejection in the case of corneal transplantation
- Irregular astigmatism requiring appropriate optical correction
- Graft opacity or failure, possibly requiring another procedure
These risks are explained in detail during the consultation, based on your condition and the technique being considered.
During a consultation dedicated to corneal conditions, your ophthalmologist will:
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- Analyze your symptoms (decreased vision, distortion, pain, photophobia, etc.)
- Perform specific examinations (topography, pachymetry, corneal imaging)
- Explain therapeutic options: medical treatment, specialized contact lenses, cross-linking, rings, transplantation, etc.
- Present the benefits, limitations, and risks of each option
The goal is to offer you personalized care, tailored to the stage of your corneal disease and your visual needs.
Consult our ophthalmology clinic for personalized advice on corneal surgery.
Book an appointment by phone at +41 (0) 22 346 26 78 or via our online booking system.
