Pterygium (winged skin): The tissue of the conjunctiva can change due to environmental influences (e.g. UV radiation) and grow over the cornea similar to a scar reaction, which is called pterygium or winged skin. This can be both cosmetically disturbing and, in the case of strong growth, can impair vision. In a pterygium operation, this excess tissue is removed from the corneal surface and at the same time the remaining diseased conjunctiva is removed in order to best prevent a renewed growth of the winged skin.
Conjunctival tumors: When cells in the conjunctiva degenerate and divide in an uncontrolled manner, tumours of the conjunctiva can occur. Such tumours can be very different in appearance (e.g. pigmented or unpigmented, raised or flat). In order to confirm the diagnosis and at the same time provide therapy, such tumours are usually surgically removed and the tissue removed is then examined under a microscope. In individual cases, cryotherapy (cold therapy, "freezing") is carried out during the operation or special eye drops (local chemotherapy) are applied after the operation, which can further reduce the risk of renewed tumour growth in certain tumours.
As a result of an illness, accident or inflammation, the cornea can become cloudy, scarred, thinned or perforated, which can lead to a deterioration in vision. In such cases a corneal transplant is necessary. The cloudy cornea or individual layers of it are replaced by a donor cornea (transplant from an organ donor). Depending on the affected layer of the cornea, different surgical procedures are available:
Perforating (penetrating) corneal transplant: Here the affected cornea is punched out in a circular pattern and removed. Afterwards a donor cornea is sewn in
Anterior (deep) lamellar corneal transplantation: Here the cornea is not completely punched out, but only the superficial, affected layers of the cornea are carefully removed. The transplant is then sutured on. Such a procedure may be considered if only superficial and not all layers of the cornea are affected.
Posterior lamellar corneal transplant (DSAEK or DMEK): This procedure is used when the innermost layer of the cornea (endothelial cell layer) is diseased. During this operation the eye is opened, the affected inner layer is removed and replaced by a corresponding layer of donor cornea. This is then pressed on with an air injection.
Keratoconus / Crosslinking
Keratoconus is a disease of the eye that is associated with a weakening of the cornea. Typical for the course of the disease is a conical bulge and thinning of the cornea, usually beginning in early puberty. The patient often notices the disease relatively late, often there is already a loss of vision with severe astigmatism. To stop the process of corneal thinning and deformation and to prevent possible scarring, the Inselspital has been offering corneal "crosslinking" for about 15 years. The cornea is stiffened using vitamin B2 and UV light and in most cases further progression of keratoconus can be successfully prevented. A special focus of the Inselspital is the treatment of children with keratoconus.
Corneal ulcer: If there is a wound healing disorder of the corneal surface, a tissue defect can develop. In individual cases, surgical coverage of the defect with an amniotic membrane (egg membrane) is necessary to prevent further deterioration up to the breaking of the cornea. The donors of such amniotic membranes are healthy women who have given birth to a child through a caesarean section and have agreed to donate an egg membrane. Under sterile conditions, the egg skin is then processed and preserved in our corneal bank. The amniotic membrane has a wound healing promoting effect due to the growth factors contained in this tissue. At the same time, the sutured on cuticle acts as a guide for the corneal cell layer to be healed, and thus also has the effect of a "bandage". This is to ensure that the corneal defect heals, thus avoiding further corneal complications (corneal perforation, infections, etc.) and ultimately preserving the eye.