The Cornea, Refractive Surgery and Cataract Unit diagnoses and treats disorders related to the eye's cornea, surface and conjunctiva. We carry out refractive surgery using an excimer laser, implants of "contact" lenses or PIOLs, torus-shaped lenses and other types to correct age-related short-sightedness, as well as cataract surgery using latest generation technology.
To guarantee excellent sight and sharp long-distance vision after surgery, the Institut de la Màcula chooses the most suitable lens to implant in the eye in order to maximise the refractive index accuracy and precision in each particular case.
- Cirugía refractivaCorneal refractive surgery
The aim of refractive surgery is to permanently reduce or eliminate dependence on optical correction (glasses or lenses).
Laser techniques, carried out on the cornea. These are most widely used for lesser degrees of myopia, hypermetropia and astigmatism.
Phakic intraocular lens techniques are normally used in more severe cases of correction or when laser techniques cannot be used for some reason.
The excimer laser we use at the center allows us to carry out personalised treatments to increase precision in correction and improve visual quality, as well as more efficiently respecting the thickness of the cornea
Phakic intraocular lenses (IOL), which respect the natural crystalline lens of the eye. ICL-type posterior chamber phakic lenses (Implantable Contact Lens) are inserted into the eye in front of the crystalline lens and behind the iris to correct high degrees of myopia, hypermetropia and astigmatism safely and effectively. In some cases they would even improve the patient's vision.
- Presbyopia surgery
Presbyopia, sometimes known as "eye strain", is the gradual loss of accommodation, involving difficulties in being able to focus on near objects. This affects everyone as from 40-50 years of age and is normally corrected with reading glasses or multifocal glasses or contact lenses.
Surgery for presbyopia includes different techniques depending on the age, correction required and characteristics of the eye. Each case is evaluated via a series of tests that help us decide the most suitable technique for each patient.
Of all the techniques being used to correct presbyopia, we recommend replacing the transparent crystalline lens with a multifocal lens implant (bifocal/trifocal) or a monofocal lens with monovision, or advanced monovision. The only definitive treatment currently available for its correction is extraction of the crystalline lens which is, due to the age-related loss of accommodation, the cause of the appearance of presbyopia.
Trifocal lenses are an innovative solution for the treatment of presbyopia.
- Cataract surgery
A cataract is one of the most common ocular alterations. It is defined as any opacity in the crystalline lens. Cataract is a pathology caused by many different factors.
Cataract surgery is the most frequent operation carried out in ophthalmology. The surgical technique of choice for removing cataracts is phacoemulsification, a microsurgery that requires no stitches.
At the Institut we carry out a personalised study of each patient. Based on the conclusions, we choose the intraocular lens with the greatest refractive precision for each patient in order to achieve the best possible quality of vision after the procedure.
Keratoconus is an alteration of the cornea in which it gradually thins in or around the centre, resulting in a deformation of its curvature and leading to short-sightedness, irregular astigmatism and a protruding cone apex.
It's very important to diagnose such patients in the early stages as the remedy and future prospects for this disorder depend on the extent of the distension of the cornea.
Minor cases of keratoconus can be corrected with glasses or contact lenses. In more acute cases RGPs or rigid contact lenses are required to correct irregular astigmatism, where the principal meridians are not perpendicular.
In those cases where the keratoconus is getting worse, CXL or corneal cross-linking has proved to be highly effective in stopping the progression of the disease.
INTACS or intrastromal corneal ring segments flatten the cornea and correct any deformity produced by the keratoconus.
In the most severe cases, when the centre of the cornea is scarred or there's significant loss of sight, this is treated by transplanting a cornea. At present, just the damaged levels of the cornea can be substituted, a procedure known as lamellar keratoplasty.
- Corneal opacity
The cornea is the anterior structure of the eye. It is made up of a transparent, avascular tissue and its main feature is its transparency, which allows light and images to pass through to the inside of the eye.
Any loss of substance, either through trauma, inflammation (keratitis), infection, dystrophy or corneal degeneration can result in corneal opacity which significantly reduces eye sight. Advanced keratoconus can deform the cornea, leading to images being severely distorted.
In these cases, treatment consists of replacing the damaged cornea.
A classic corneal transplant replaces all layers of the host's central corneal disc with a donor cornea. This is called penetrating keratoplasty.
The current trend is to carry out partial transplants of just one or more of the corneal layers depending on the location of the pathology, differentiating between deep anterior lamellar keratoplasty (DALK) and the posterior forms (DSEK, DSAEK, DMEK).
Corneal transplants are currently the most common and the most successful surgical procedures being carried out in the field of transplant medicine.
- Dry eye
Dry eye syndrome represents a varied group of disorders characterised by symptoms of ocular discomfort and associated with a reduction in the production of tears or abnormally fast evaporation of the tear film.
The prevalence of dry eye syndrome increases with age and affects approximately 30 % of the adult population. It's a chronic and very frequent pathology.
In the Institut specific tests are carried out on each patient to determine the most appropriate treatment in each case. We have the newest treatments for dry eyes in its different stages, mild, moderate and severe, such as topical cyclosporine, acetylcysteine, autologous serum, punctal plugs, humid chamber and lateral tarsorrhaphy, in cases of severe dry eye.
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