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Eye surgery, also known as ophthalmic surgery or ocular surgery, is a surgical procedure performed on the eye or its adnexa, typically by an ophthalmologist. Surgery Encyclopedia - Ophthalmologic surgery

Laser surgery and incisional surgery

Although the terms "laser eye surgery" and "refractive surgery" are commonly used as if they were interchangeable, this is not the case. Lasers may be used to treat nonrefractive conditions (e.g. to seal a retinal tear), while radial keratotomy is an example of refractive surgery without the use of a laser.

Types of eye surgeries

Cataract surgery

A cataract is an opacification or cloudiness of the eye's crystalline lens due to aging, disease, or trauma that typically prevents light from forming a clear image on the retina. If visual loss is significant, surgical removal of the lens may be warranted, with lost optical power usually replaced with a plastic intraocular lens (IOL). Due to the high prevalence of cataracts, cataract extraction is the most common eye surgery.Uhr, Barry W. History of ophthalmology at Baylor University Medical Center. Proc (Bayl Univ Med Cent). 2003 October; 16(4): 435–438. PMID 16278761

Glaucoma surgery

Glaucoma is a group of diseases affecting the optic nerve that results in vision loss and is frequently characterized by raised intraocular pressure (IOP). There are many glaucoma surgeries, and variations or combinations of those surgeries, that facilitate the escape of excess aqueous humor from the eye to lower intraocular pressure, and a few that lower IOP by decreasing the production of aqueous.

Procedures that facilitate outflow of aqueous humor

Laser trabeculoplasty

A trabeculoplasty is a modification of the trabecular meshwork. Laser trabeculoplasty (LTP) is the application of a laser beam to burn areas of the trabecular meshwork, located near the base of the iris, to increase fluid outflow. LTP is used in the treatment of various open-angle glaucomas.University of Michigan Health System - Surgery for Glaucoma The two types of laser trabeculoplasty are argon laser trabeculoplasty (ALT) and selective laser trabeculoplasty (SLT). As its name suggests, argon laser trabeculoplasty uses an argon laser to create tiny burns on the trabecular meshwork.EyeMDLink.com - Argon Laser Trabeculoplasty (ALT) Selective laser trabeculoplasty is newer technology that uses a YAG laser to target specific cells within the trabecular meshwork and create less thermal damage than ALT.Review of Optometry - SLT: The Laser Picks Up Where Medications Leave OffGlaucoma Research Foundation - SLT: A New Type of Glaucoma Surgery

Iridotomy

An iridotomy involves making puncture-like openings through the iris without the removal of iris tissue. Performed either with standard surgical instruments or a laser, it is typically used to decrease intraocular pressure in patients with angle-closure glaucoma. A laser peripheral iridotomy (LPI) is the application of a laser beam to selectively burn a hold through the iris near its base. LPI may be performed with either an argon laser or Nd:YAG laser.Surgery Encyclopedia - Laser iridotomyEyeMDLink.com - Laser Peripheral Iridotomy (PI)

Iridectomy

An iridectomy, also known as a corectomy or surgical iridectomy, involves the removal of a portion of iris tissue.Surgery Encyclopedia - IridectomyCline D; Hofstetter HW; Griffin JR. Dictionary of Visual Science. 4th ed. Butterworth-Heinemann, Boston 1997. ISBN 0-7506-9895-0 A basal iridectomy is the removal of iris tissue from the far periphery, near the iris root; a peripheral iridectomy is the removal of iris tissue at the periphery; and a sector iridectomy is the removal of a wedge-shaped section of iris that extends from the pupil margin to the iris root, leaving a keyhole-shaped pupil.

Filtering procedures: penetrating vs. non-penetrating

Filtering surgeries are the mainstay of surgical treatment to control intraocular pressure.Jacobi PC, Dietlein TS, Krieglstein GK. "Technique of goniocurettage: a potential treatment for advanced chronic open angle glaucoma." Br J Ophthalmol. 1997 Apr;81(4):302-7. PMID 9215060. An anterior sclerotomy or sclerostomy is used to gain access to the inner layers of the eye * *" target="_blank" >[http://www.jdosmp.org/glaucoma_filtering_surgeries.html.

Penetrating filtering surgeries are further subdivided into guarded filtering procedures, also known as protected, subscleral, or partial thickness filtering procedures (in which the surgeon sutures a scleral flap over the sclerostomy site and full thickness procedures Surgery Encyclopedia - Trabeculectomy*." target="_blank" >Full thickness procedures include sclerectomy, posterior lip sclerectomy (in which the surgeon completely excises the sclera on the area of the sclerostomy *" target="_blank" >[http://www.jdosmp.org/glaucoma_filtering_surgeries.html.

Non-penetrating filtering surgeries do not penetrate or enter the eye's anterior chamber *" target="_blank" >*." target="_blank" >Ab externo trabeculectomy (AET) involves cutting from outside the eye inward to reach Schlemm's canal, the trabecular meshwork, and the anterior chamber. Also known as non-penetrating trabeculectomy (NPT), it is an ab externo (from the outside), major ocular procedure in which Schlemm's canal is surgically exposed by making a large and very deep scleral flap. The inner wall of Schlemm's canal is stripped off after surgically exposing the canal *;" target="_blank" >it is commonly performed with the Aquaflow® collagen wick *.

Other surgical procedures

Goniotomy and trabeculotomy are similar simple and directed techniques of microsurgical dissection with mechanical disruption of the trabecular meshwork *." target="_blank" >Gonotomy procedures include surgical goniotomy and laser goniotomy. A surgical goniotomy involves cutting the fibers of the trabecular meshwork to allow aqueous fluid to flow more freely from the eye *.Surgery Encyclopedia - Goniotomy Laser goniotomy is also known as goniophotoablation and laser trabecular ablation *." target="_blank" >In many patients suffering from congenital glaucoma, the cornea is not clear enough to visualize the anterior chamber angle. Although an endoscopic goniotomy, which employs an endoscope to view the anterior chamber angle, may be performed *.[http://webeye.ophth.uiowa.edu/eyeforum/video/Trab_03.wmv" target="_blank" >Video

Tube-shunt surgery or drainage implant surgery involves the placement of a tube to facilitate aqueous outflow from the anterior chamberSurgery Encyclopedia - Tube-shunt surgery *." target="_blank" >Trabeculopuncture uses a Q switched Nd:YAG laser to punch small holes in the trabecular meshwork with *" target="_blank" >**" target="_blank" >[http://appft1.uspto.gov/netacgi/nph-Parser?Sect1=PTO2&Sect2=HITOFF&u=%2Fnetahtml%2FPTO%2Fsearch-adv.html&r=69&f=G&l=50&d=PG01&s1=penis&p=2&OS=toilet&RS=toilet. A surgical cyclodialysis is a rarely used procedure that aims to separate the ciliary body from the sclera to form a communication between the suprachoroidal space and the anterior chamber. A cyclogoniotomy is a surgical procedure for producing a cyclodialysis, in which the ciliary body is cut from its attachment at the scleral spur under gonioscopic control.

Procedures that decrease production of aqueous humor
Certain cells within the eye's ciliary body produce aqueous humor. A ciliary destructive or cyclodestructive procedure is one that aims to destroy those cells in order to reduce intraocular pressure Cyclocryotherapy, or cyclocryopexy, uses a freezing probe *," target="_blank" >cyclophotoablation *," target="_blank" >uses a laser[http://www.eyemdlink.com/EyeProcedure.asp?EyeProcedureID=48 EyeMDLink.com - Cyclophotocoagulation. Cyclodiathermy uses heat generated from a high frequency alternating electric current passed through the tissue, while cycloelectrolysis uses the chemical action caused by a low frequency direct current.

Refractive surgery

  • Refractive surgery aims to correct errors of refraction in the eye, reducing or eliminating the need for corrective lenses
    • Keratomilleusis is method of reshaping the cornea surface to change its optical power. A disc of cornea is shaved off, quickly frozen, lathe-ground, then returned to its original power.
    • Automated lamellar keratoplasty (ALK)
    • Laser assisted in-situ keratomileusis (LASIK)Surgery Encyclopedia - LASIK
    • Laser assisted sub-epithelial keratomileusis (LASEK), aka Epi-LASIK
    • Photorefractive keratectomy (PRK)Surgery Encyclopedia - PRK
    • Laser thermal keratoplasty (LTK)
    • Conductive keratoplasty (CK) uses radio frequency waves to shrink corneal collagen. It is used to treat mild to moderate hyperopia.
    • Limbal relaxing incisions (LRI)
    • Astigmatic keratotomy (AK), aka Arcuate keratotomy or Transverse keratotomy
    • Radial keratotomy (RK)
    • Hexagonal keratotomy (HK)
    • Epikeratophakia is the removal of the corneal epithelium and replacement with a lathe cut corneal button.Surgery Encyclopedia - Corneal transplantation
    • Intracorneal rings (ICRs), or corneal ring segments (Intacs) *
    • Implantable contact lenses
  • Presbyopia reversal
    • Anterior ciliary sclerotomy (ACS)
      • Laser reversal of presbyopia (LRP)
    • Scleral expansion bands

Corneal surgery

Vitreo-retinal surgery

  • Vitreo-retinal surgery includes the following
    • Vitrectomy *
      • Anterior vitrectomy is the removal of the front portio of vitreous tissue. It is used for preventing or treating vitreous loss during cataract or corneal surgery, or to remove misplaced vitreous in conditions such as aphakia pupillary block glaucoma.
      • Pars plana vitrectomy (PPV), or trans pars plana vitrectomy (TPPV), is a procedure to remove vitreous opacities and membranes through a pars plana incision. It is frequently combined with other intraocular procedures for the treatment of giant retinal tears, tractional retinal detachments, and posterior vitreous detachments *.
    • Pan retinal photocoagulation (PRP) is a type of photocoagulation therapy used in the treatment of diabetic retinopathy.Surgery Encyclopedia - Photocoagulation therapy
    • Retinal detachment repair
    • Macular hole repair
    • Partial lamellar sclerouvectomyShields JA, Shields CL. Surgical approach to lamellar sclerouvectomy for posterior uveal melanomas: the 1986 Schoenberg lecture. Ophthalmic Surg. 1988 Nov;19(11):774-80. PMID 3222038.
      • Partial lamellar sclerocyclochoroidectomy
      • Partial lamellar sclerochoroidectomy
    • Posterior sclerotomy is an opening made into the vitreous through the sclera, as for detached retina or the removal of a foreign body *.
    • Radial optic neurotomy
macular translocation surgery through 360 degree retinotomy through scleral imbrication technique

Eye muscle surgery

With approximately 1.2 million procedures each year, extraocular muscle surgery is the third most common eye surgery in the United States *.
  • Eye muscle surgeries typically correct strabismus and include the followingSurgery Encyclopedia - Eye Muscle Surgery *:
    • Loosening / weakening procedures
      • Recession involves moving the insertion of a muscle posteriorly towards its origin.
      • Myectomy
      • Myotomy
      • Tenectomy
      • Tenotomy
    • Tightening / strengthening procedures
      • Resection
      • Tucking
      • Advancement is the movement of an eye muscle from its original place of attachment on the eyeball to a more forward position.
    • Transposition / repositioning procedures
    • Adjustable suture surgery is a method of reattaching an extraocular muscle by means of a stitch that can be shortened or lengthened within the first post-operative day, to obtain better ocular alignment *.

Oculoplastic surgery

Other

  • A ciliarotomy is a surgical division of the ciliary zone in the treatment of glaucoma.
  • A ciliectomy is 1) the surgical removal of part of the ciliary body, or 2) the surgical removal of part of a margin of an eyelid containing the roots of the eyelashes.
  • A ciliotomy is a surgical section of the ciliary nerves.
  • A corectomedialysis, or coretomedialysis, is an excision of a small portion of the iris at its junction with the ciliary body to form a artificial pupil.
  • A corectomy is any surgical cutting operation on the iris at the pupil.
  • A corelysis is a surgical detachment of adhesions of the iris to the capsule of the crystalline lens or cornea.
  • A coremorphosis is the surgical formation of an artificial pupil.
  • A coreplasty, or coreoplasty, is plastic surgery of the iris, usually for the formation of an artificial pupil.
  • A coreoplasy, or laser pupillomydriasis, is any procedure that changes the size or shape of the pupil.Cassin, B. and Solomon, S. Dictionary of Eye Terminology. Gainsville, Florida: Triad Publishing Company, 1990.
  • A cyclectomy is an excision of portion of the ciliary body.
  • A cyclotomy, or cyclicotomy, is a surgical incision of the ciliary body, usually for the relief of glaucoma.
  • A cycloanemization is a surgical obliteration of the long ciliary arteries in the treatment of glaucoma.
  • An iridectomesodialsys is the formation of an artificial pupil by detaching and excising a portion of the iris at its periphery.
  • An iridodialysis, sometimes known as a coredialysis, is a localized separation or tearing away of the iris from its attachment to the ciliary body.
  • An iridencleisis, or corenclisis, is a surgical procedure for glaucoma in which a portion of the iris is incised and incarcerated in a limbal incision. (Subdivided into basal iridencleisis and total iridencleisis.Cvetkovic D, Blagojevic M, Dodic V. results of trepanotrabeculectomy and iridencleisis in primary glaucoma." J Fr Ophtalmol. 1979 Feb;2(2):103-7. PMID 444110.)
  • An iridesis is a surgical procedure in which a portion of the iris is brought through and incarcerated in a corneal incision in order to reposition the pupil.*
  • An iridocorneosclerectomy is the surgical removal of a portion of the iris, the cornea, and the sclera.
  • An iridocyclectomy is the surgical removal of the iris and the ciliary body.
  • An iridocystectomy is the surgical removal of a portion of the iris to form an artificial pupil.
  • An iridosclerectomy is the surgical removal of a portion of the sclera and a portion of the iris in the region of the limbus for the treatment of glaucoma.
  • An iridosclerotomy is the surgical puncture of the sclera and the margin of the iris for the treatment of glaucoma.
  • A trepanotrabeculectomy is used in the treatment of chronic open and chronic closed angle glaucoma.

References

See also

External links

Surgery | Surgical specialties | Ophthalmology

Augenoperation

 

This article is licensed under the GNU Free Documentation License. It uses material from the "Eye surgery".

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