Surgical Interventions and Minimally Invasive procedures

Surgical removal of eyelid lesions

The surgical removal of various skin lesions that appearing on the eyelids are usually for aesthetic reasons (xanthomas, cysts, papillomas, etc.) or diagnostic (removal of nevi, biopsy, etc.). As a rule, these operations are carried out under local anaesthesia and depending on the size of the removed lesion, sutures may or may not be required.

Surgical removal of stye( chalazion) - hordeolum

Required when the aforementioned conditions do not resolve with conservative treatment (eye drops/ointments) or when they cause aesthetic problem. Removal is carried out from the inner side of the eyelid, so that no aesthetic effect is left and usually no sutures are required. Because chalazion/hordeolum may reappear in another part of the same or even the other eyelid, a long-term care/healthy treatment is usually required on the eyelid area, especially in people prone to the occurrence of such conditions.

Lacrimal drainage system crossing

This procedure is performed in patients with chronic epiphora and is mainly diagnostic: to determine lacrimal system’s drainage effectiveness. Initially, it is carried out dilation of the lacrimal puncta, the nasal orifices at the tip of the eyelids where the tear drainage system begins. Then, metal catheters(blunt-tipped) are inserted through the lacrimal puncta into the lumen of the canaliculi. In the final phase of the operation,normal saline is injected through a special needle into the tear tubes. It is possible that the above manipulations may have a therapeutic effect, especially if tearing is due to narrowing/obstruction of the lacrimal points or tubules. Thus, the patients are relieved of their symptoms, even if only temporarily. However, if stenosis/obstruction involves the nasolacrimal duct, then a large-scale operation, ascorinostomy, is required.

Restoration of blepharoptosis (upper eyelid drop)​

By the term blepharoptosis, we define the phenomenon of drop of one or both upper eyelids. In many cases, when drop is severe, this condition can even affect vision.

In addition to the aesthetic problem, in severe cases the the patient has to raise his head or eyelid in order to see. Blepharoptosis is not a disease, but a symptom of another condition that needs to be treated.

What are the symptoms?
Blepharoptosis does not tend to cause symptoms until the eyelid obstructs the patients field of vision (reduced peripheral vision).
Symptoms tend to be worse when the patient is looking upwards or when tired.
A compensatory effort to raise the patients eyelids to a higher level is done by raising the eyebrows, and this can itself lead to pain above the eyebrows or to pronounced headache.

Is there a cure for eyelid drooping?
Treatment varies depending on the cause of the blepharoptosis. In cases of congenital blepharoptosis, you may need surgery. Immediately after surgery you may have problems with opening and closing your eyelids but soon this function will return. Children who have blepharoptosis have an increased risk of developing amblyopia. Treatment for amblyopia includes closing the good eye so that the other eye can function better.

Ectropion

Ectropion, as opposed to entropion, is a condition of the eyelids, in which the lower eyelid turns outward, or hangs away from the eye.

What causes ectropion?
Usually ectropion is the result of relaxation of the tissues due to age-related degeneration, although it can also occur due to paresis of the facial nerve, trauma, scarring, previous surgery or skin cancer.

What are the symptoms of ectropion?
Symptoms depend on the degree of ectropion, and include the following:

• Excessive tearing
• Chronic irritation
• Redness
• Pain
• Foreign body sensation
• Mucous and purulent discharge
  
  

Can ectropion be corrected?
The treatment of ectropion depends on the underlying cause. Often, surgery is required in which the lower limb is removed and the eyelid is tightened at its outer corner (outer canthus). This is done under local anaesthesia and takes about 40 minutes. The more complex cases (including those there has been previous injury or surgery, or facial nerve paresis) need more specialised surgical treatment . After surgery, the eye remains closed for one day to reduce swelling, and the following day are administered antibiotic drops or an ointment. A re-examination is scheduled in 2 weeks to check the position of the eyelid and remove the stitches.

Entropion

What is entropion?

Entropion is a condition in which the limb of the upper or lower eyelid is turned inwards against the surface of the eye.

Can entropion pose a risk to the eye and vision?

Entropion carries a significant risk of corneal trauma which is the front part of the eye. Complications of entropion include the following:

• Corneal erosions (causing irritation of the eye, tearing and redness)
• Corneal ulcers (leading to more significant symptoms, which can cause blurred vision, worsening pain, sensitivity to light, and annoying tearing).

What is the treatment for entropion?

Treatment of entropion depends on the cause, but requires often a surgical procedure to turn the eyelid rim and eyelashes away from the eye.

Daily cleaning of the eyelids, and mild lubricants can be used to help temporarily relieve any discomfort, redness or pain. This, however, is not a permanent solution for entropion, but can help improving symptoms and breaking the vicious circle of eye irritation and pressure on the eyelid.

Cataract surgery

Cataract is the clouding of the lens of the eye. It is manifested in the context of normal aging of the body, but it can also be caused by diseases or injuries, while it is rarely congenital (congenital cataract). It cannot be treated or prevented with medication and the only way to treat is to remove the clouding lens and replace it with an artificial one. The crystalline lens is located behind the iris (the coloured part of the eye), inside a transparent bag called the capsule.

What is Cataract Surgery?

Cataract surgery is a common and safe procedure that aims to remove the cloudy crystalline lens of the eye and replacing it with a clear intraocular lens. This operation restores the vision affected by the cataract, improving patient's daily lives. The procedure is short and painless and is usually performed with local anaesthesia.

Procedure and Recovery from Cataract Surgery:

The cataract surgery procedure includes removing the cloudy lens and replacing it with a new artificial lens. The procedure usually takes 30 minutes and the patient can return home the same day. Recovery is fast and most patients notice a significant improvement in their vision within a few days. Patients should follow their doctor's instructions for eye care after surgery to ensure the best possible recovery.

Surgical Excision of Pterygium

Pterygium surgical removal is required when it grows and increases in size, invading the cornea and create various problematic conditions, such as: high astigmatism, occlusion of the visual axis and/or aesthetic problem.

Simple removal of pterygium is accompanied by very high rates of recurrence rates. It is therefore recommended that its removal be accompanied by the use of specific drugs (mitomycin) and/or the placement of grafts.

In any case, it is advisable for the patient to undergo surgery before the flap has grown excessively in size, because on the one hand the operation becomes more difficult and the post-operative recovery more gradual, on the other hand, permanent lesions are left in the cornea (scars) which are particularly difficult to correct.

Refractive Surgery

PRK

The PRK method is very effective in the correction of small degrees myopia, with or without astigmatism, but also in higher degrees, if the cornea is relatively thin. A very thin Laser beam is applied to the surface of the cornea. Following this technique, corneal flap is not created but the superficial membrane of the cornea is removed (epithelium), with a special tool, and the treatment with the Excimer Laser is applied. At the end of the procedure, a contact lens is placed to help the epithelium to heal over the next three to four days. The procedure is only a few minutes long and is performed using a local anaesthetic.

Femto Lasik

Today, in the quiver of refractive surgeons has entered the Femtosecond Laser. Femtosecond Laser uses pulses of light, which penetrate the corneal surface and shape small cavities (bubbles) at a predetermined depth and position within the cornea. The result of the application of Femtosecond Laser is the creation of a uniform layer of bubbles in the cornea. Using a special spatula, the surgeon proeeds the final separation of the flap from the rest of the cornea. Then the surgeon can apply the treatment with the Excimer Laser. Compared to the mechanical microkeratome, the creation of the flap using Femtosecond technology is a more efficient way to create predictable and more controlled procedure. The thickness, the diameter, the angle of the flap boundaries, the position in which it remains fused with the cornea (pedicle/hinge) and the angle of the hinge are defined by the surgeon before applying the Femtosecond Laser.