Superficial keratectomy serves as both an elective procedure and as a necessary one. Certain circumstances make it needed for some people who are in line for cataract surgery.
According to researchers writing for Review of Ophthalmology, the following existing conditions typically call for superficial keratectomy ahead of cataract surgery:
- Anterior basement membrane dystrophy
- Band keratopathy
- Salzmann's nodular degeneration
Anterior Basement Membrane Dystrophy
This hallmark of this condition is tiny dots or specks in the cornea that prevent the cornea from sticking together. As corneal layers separate apart, vision grows worse. Patients experience blurred vision or double vision.
Band keratopathy involves a band of salts across the surface of the cornea. The denser the salt layer, the more it impacts one’s vision. Significant vision loss is possible.
Salzmann's Nodular Degeneration
When blue, white or bluish-white nodes pop up above the surface of the cornea, doctors identify Salzmann’s nodular degeneration. The nodes lead to an inadequate of tears, which make it difficult for anyone with the condition to wear contact lenses.
All three circumstances can cause corneal tugging and thinning, which increases the risk of complications during and after cataract surgery. Even if your doctor inserts the perfect lens inside your eye during the cataract procedure, issues with your cornea will prevent the operation from being a full success.
By removing the abnormalities and smoothing the surface of the eye, your doctor ensures that you have the best chance at a successful cataract Your doctor will want to correct any eye health problems before surgery.
Even so, some eye health problems do return. In a study in the Canadian Journal of Ophthalmology, corneal health problems treated with superficial keratectomy came back in 24 percent of the time.
At the end of an ideal cataract surgery, you will see clearly. To make that happen, you will have the opportunity to choose the type of lens that sits inside your eye. But even with the right lens and the right surgeon, you could struggle with crisp vision after surgery if the surface of your eye is uneven.
Superficial keratectomy is the surgical removal of the eye's surface tissues. It's a quick procedure that is typically complete in a few minutes.
People who need this surgery before their cataracts are touched have eye health issues like nodular degeneration or band keratopathy.
But you might also want the surgery if you hope to use a multifocal lens in your cataract surgery or if you want tight control over how well you can see when the work is done.
What Is the Surgery Like?
Cataract surgery is the replacement of the lens inside your eye. Superficial keratectomy is the removal of layers of tissue on the outside of your eye. Since the inside and the outside of your eye work together to give you clear vision, your doctor might choose to perform both procedures either at the same time or close together.
The American Academy of Ophthalmology says superficial keratectomy is over in 15 to 30 minutes. Your doctor will:
- Sedate you. Drops to numb your eyes or general anesthetic to calm your whole body start the process.
- Loosen. Alcohol or another agent helps to separate surface tissues from those that lie beneath.
- Remove. A blade, brush, or laser polishes the cornea's surface.
- Bandage. A contact lens covers the eye as it heals.
Who Might Want This Surgery?
Some people need superficial keratectomy due to eye health problems, but others might want to consider the procedure to ensure that their cataract surgery goes as smoothly as possible.
For example, some people hope to use a multifocal lens to replace their clouded one. These new lenses have several different spots of focus of varying strengths, and in time, the brain learns to use that varying magnification power. With these lenses, people have a smaller chance of needing glasses or contacts.
These are powerful tools, but they are also very precise. To make sure you have the right strength and power of lens, your doctor must make very delicate measurements of your eyes. Superficial keratectomy can remove minor abnormalities, so your doctor can make the most accurate lens choice for you.
Researchers writing for Ocular Surgery News also point out that superficial keratectomy can improve vision and reduce the need for correction. People with significant vision problems might appreciate a touch of correction before cataract surgery, so they do not need a significantly strong lens implanted.
People who dislike risks and want control can benefit from superficial keratectomy, as the results of cataract surgery are just more predictable when the two procedures are combined. But doctors can help to make the right decision. You do not have to decide alone whether this is the right step for you to take. Your doctor can steer you in the right direction.
Frequently Asked Questions
Does superficial keratectomy improve vision?
Superficial keratectomy corrects abnormalities or erosion in the epithelium, the cornea’s outer layer. The procedure smooths the surface of the eye and improve your ability to make out the details and shape of objects (visual acuity).
How long is the recovery time from superficial keratectomy?
You may experience blurry vision and swollen red eyes immediately after the surgery, but you should see clearly and be rid of any puffiness within a few days. It takes about six to eight weeks for a full recovery. The doctor will prescribe eye drops for regular application to aid the healing process.
How Is Corneal Scraping Surgery Performed? (August 2016). American Academy of Ophthalmology.
Smooth Operator. (October 2013). Review of Ophthalmology.
Optimize Cataract Surgery Outcomes by Addressing Corneal Pathology. (September 2015). Ocular Surgery News.
Superficial Keratectomy: Indications and Outcomes. (December 2018). Canadian Journal of Ophthalmology.
Superficial keratectomy. (March 2015). University of Michigan Health System.
Superficial keratectomy: indications and outcomes. (December 2018). National Library of Medicine.