THE VALUE OF GÕOD EYESIGHT
There are several pathologies or affections of the cornea that can alter its transparency or shape, hindering the passage of light and causing vision problems. In these cases, depending on the layer of the cornea affected, one treatment or another will be chosen. The most common eye diseases that can affect the cornea and require a transplant are usually degenerative (keratoconus) or dystrophic (Fuchs disease) corneal pathologies, corneal ulcers or keratitis secondary to contact lenses or ocular herpes, and corneal edema due to complications from other surgeries.
At visiõnclínic+ we have extensive experience in the treatment of corneal pathologies. The professionals in our team perform more than 100 cornea transplants a year and are part of the Ophthalmology Service of the Hospital Clínic, Reference Service (CSUR) of the National Health System (SNS).
Ophthalmologist specialist in corneal transplantation and refractive surgery
FIRST VISIT AND EYE EXAMINATION
For the diagnosis of any corneal pathology, we must carry out a complete eye examination to discover the specific condition and determine the best treatment for your case.
WHY CHOOSE VISIÕNCLÍNIC+ FOR CORNEA TREATMENT?
Our professionals are part of the Ophthalmology Service of the Clínic Barcelona, integrated in the Referral Service (CSUR) of the National Health System (SNS). Both Dr. Jorge Peraza-Nieves and Dr. Josep Torras participate in the more than 100 corneal transplants per year that are performed at this centre, making it one of the hospitals that perform the most transplants in the country.
At visiõnclínic+ we use the latest technology available on the market for the treatment of corneal pathologies. Our close collaboration with the pharmaceutical industry allows us to offer state-of-the-art treatments, such as cross-linking or intracorneal methacrylate segments for the treatment of keratoconus. In addition, the new visiõnclínic+ surgical area is equipped with the latest advances for corneal surgery (refractive or transplant), such as our femtosecond laser. Finally, the fact that our professionals are part of the Clínic Barcelona, and thanks to the centre’s relationship with the Tissue Bank of Catalonia, has allowed them to be pioneers when it comes to using new preparations of corneal donor tissue.
At visiõnclínic+ we have a team made up of ophthalmologists from Clínic Barcelona and barnaclínic+, specialists not only in the treatment of corneal diseases and corneal surgery, but in all areas of ophthalmology. In addition, we work with a team of optometrists, which allows us to offer a comprehensive range of services in support of your visual health.
LEADERS IN RESEARCH
Visiõnclínic+ is part of the Clínic Barcelona Group and all members of our team are part of its Ophthalmology Service. As part of the “Ocular inflammation: clinical and experimental studies” Group of the August Pi i Sunyer Biomedical Research Institute (IDIBAPS), they focus their work on translational research, from basic research to clinical application. In this sense, the clinical trial carried out by the Hospital Clínic with cultured corneal epithelial stem cells, already applicable in the clinic, is particularly relevant.
DIAGNOSIS OF CORNEA DISEASES
Among the existing tests for the diagnosis of problems and pathologies of the cornea available to the ophthalmologist are keratometry, slit lamp examination, pachymetry or corneal topography.
All these tests are part of our preliminary study or visual health package and are carried out at the first consultation of a patient who wants to have refractive surgery to correct myopia, hypermetropia or astigmatism.
DISEASES OF THE CORNEA
Corneal ulcer is an eye pathology that occurs in the outermost layers of the cornea. If a corneal ulcer becomes complicated, it can have visual consequences and require a corneal transplant. Because of this, it is important to treat it in time. Its origin can be due to trauma, abrasion, dry eye syndrome, problems with the eyelids, or infections (viral, bacterial, fungal and protozoan).
Corneal edema is an inflammation of the cornea caused by fluid retention. In corneal edema, the corneal endothelium (the innermost layer) stops working properly and fluid accumulates, losing transparency. The origin of corneal edema can be infection or trauma, but the most common cause is a decrease in endothelial cells of genetic cause. Corneal edema is diagnosed using tests such as slit lamp examination or endothelial microscopy.
Keratitis is an inflammation of the cornea. When the inflammation simultaneously affects the cornea and the conjunctiva, we speak of keratoconjunctivitis. Its origin can be in eyelid problems, dry eye syndrome, immunological disorders, irritations from external agents, and infections. Keratitis usually affects the outermost corneal layers. They must be treated in time, as they could evolve into corneal ulcers.
Keratoconus is one of the most common corneal diseases. It consists of a thinning of the cornea, causing an increase in its curvature. The cornea takes on a conical shape which produces the progressive loss of vision. One of the most common symptoms of keratoconus is the distortion of images and a visual decrease that worsens without the possibility of correction. Early diagnosis of keratoconus is essential for its treatment. Corneal topography is mainly used for the diagnosis of keratoconus. When keratoconus is detected at an early stage, the use of rigid contact lenses is the best choice, but simple surgery is the best treatment to slow down its progression. In advanced cases of keratoconus, a corneal transplant may be necessary.
Corneal neovascularisation is an ocular pathology characterised by the growth of blood vessels in the cornea. In corneal neovascularisation, there is a reaction to the lack of oxygen in the corneal tissue, causing blood vessels to grow that hinder the transparency of the cornea and compromise visual acuity. In addition, in patients with a previous corneal transplant it may be a risk factor for immune rejection. The most common causes of corneal neovascularisation are: infectious processes, an immunological response, the incorrect use of contact lenses, a malfunction of the corneal innervation, trauma or dry eye syndrome.
Fuchs’ dystrophy is an eye disease that affects the endothelium, the deepest layer of the cornea. The function of the endothelium is to keep the cornea transparent and dehydrated, allowing the passage of light. When Fuchs’ dystrophy occurs, the function of the endothelium is lost: fluid passes into the stoma and corneal edema occurs. It has a genetic origin, and currently the most effective treatment is endothelial transplantation (DMEK).
Among retinal pathologies of vascular origin, the most frequent are diabetic retinopathy and retinal vascular occlusions, mainly those of the thrombotic type that affect the veins. In this type of pathology, the treatment usually combines laser photocoagulation and intravitreal therapies through intraocular injections. It is necessary to focus on modifiable risk factors such as: hyperglycaemia, hypercholesterolemia or arterial hypertension.
WHAT IS CORNEA TRANSPLANTATION?
Corneal transplantation or keratoplasty, as the surgical technique is known, is a procedure consisting of replacing damaged corneal tissue with healthy tissue from a donor. It is performed when the visual impairment is irreversible and there is no other treatment option to correct it.
Corneal diseases that can alter to a greater degree its shape or transparency, and require a transplant, are keratoconus, corneal ulcers and endothelial diseases. Depending on the layer of the affected cornea, one or another type of cornea transplant will be performed: penetrating keratoplasty, deep anterior lamellar (DALK) or endothelial (DSAEK/DMEK).
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