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Corneal Consultation and Surgical Co-Management

Pk’s-penetrating Keratoplastys, DSEK’S-Descemets Stripping Endothelial Keratoplasty, ALK- Anterior Lamellar Keratoplasty), P.T.K. (Photo Therapeutic Keratectomy) referral and management to remove or decrease level of herpetic scaring or to treat corneal basement diseases  and lastly corneal diseases like Fuchs and Herpes Keratitis  and associated manifestations. As mentioned with our surgical laser refractive patients we can initially measure their corneal thickness and or anomaly characteristics with our OCT anterior lens. With our keratoconic patients and post cataract patients who exhibited corneal guttata pre surgically we can monitor their endothelial corneal comprise post cataract surgery to more logically explain the reduction in best visual acuity with our Pachymeter and anterior lens affixed our O.C.T. a double and reinforceable set of findings. In this way steroids and hypertonic saline drops and gels can be employed to retain corneal clarity where the deturgescence (imbibing corneal edema) endothelial cellular bilge mechanism is failing. Cataract surgery exacerbates endothelial compromise an estimated 7 to 8 percent in persons with previous endothelial (posterior corneal compromise). The care used and choice of viscoelastic used in cataract surgery can greatly reduce the likelihood of this and use of a laser over Phaco chop to emulsify the lens material.