Surgery helps to treat band keratopathy. This article gives information about the procedure involved in the surgery.
Surgical Care
- Usually, band keratopathy surgical debridement is very effective to restore normal vision. The surgery can be carried out in a minor operating room and the patient is given topical anesthesia. Tetracaine or proparacaine drops can be used as anesthesia. Operating microscope is used.
- In order to hold the eyelids open, a lid speculum is placed.
- Debride the epithelium that is precipitated with calcium using a spatula or an ophthalmic surgical blade.
- Apply 1.5%, 0.05 mol neutral disodium ethylenediamine tetraacetic acid, to the surface of the cornea. Weck-cel sponges are soaked in this solution and can be used for cleaning the corneal surface.
- Then, calcium deposits are removed by scraping the surface of the cornea using a blunt spatula. Often, the solution is applied following scraping several times in order to remove the plaques.
- Calcium deposits which are thin can come off within 5 minutes, but thick plaques may dissolve in 30-45 minutes.
- Once this is completed, the underlying stroma can be smoothened. If the surface is irregular, phototherapeutic kerectomy using an excimer laser can help to smooth the surface. This procedure is also performed in the same way.
- It is important to know that calcium should not be removed using excimer laser. Attempt made to remove band keratopathy using excimer laser can result in irregular astigmatism because not the calcium, but the cornea will be removed preferentially.
- Excimer is used only to polish or smooth the surface after removing the plaque.
- Thoroughly, irrigate the eye following the procedure in order to remove EDTA (ethylenediamine tetraacetic acid) solution from the surface of the conjunctiva and fornices.
- Then bandage contact lens are placed over the cornea. Alternatively, frequent antibiotic ointment or pressure patching can be used.
Postoperative Care
- Bandage contact lens are placed until the epithelium heals.
- To control pain, topical non steroidal agents are used.
- An antibiotic drops are also recommended.
- Topical steroid drops can be used to provide comfort and treat corneal edema and the inflammation.
- After the epithelium has healed, use of all these medications can also be stopped.
