|Year : 1979 | Volume
| Issue : 4 | Page : 195-196
Surgical management of myopia
KK Gupta, BS Jain, DJ Pandey
G.S.V.M. Med. College, Kanpur, India
K K Gupta
Prof. of Ophthalmology G.S.V.M. Med. College Kanpur
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Gupta K K, Jain B S, Pandey D J. Surgical management of myopia. Indian J Ophthalmol 1979;27:195-6
In an effort to discard glasses ophthalmologists over the centuries have attempted various surgical procedures for the correction of myopia. The various operations like lens extractions, anterior sclerectomy, keratoprosthesis and keratomilieusis have not proved satisfactory. These surgical operations are either too risky with doubtful prognostic value or grossly alter the physiological optics and the accomodation of the eye. Lately radial corneal incisions have been tried which produce variable reductions in corneal curvatures resulting in correction or reduction of myopia. Some of the radial scars of the cornea tried produce disfiguration of the cornea, making its universal acceptance difficult.
With the view to overcome the just mentioned shcrtcomings we have thought of producing corneal scar which should be least visible, safe and effective. We have tried three variations of corneal scars in the peripheral part of the cornea close to the limbus.
| Materials and Methods|| |
The present paper is a preliminary study of 21 cases in which three simple corneal scar patterns were made and their relative values in the correction of myopia were analysed.
I. In the first group of nine cases, a single scar in the peripheral part of the cornea about one milimeter inside the limbal margin and 0.60 milimeter in depth was made with the help of Franceschetti's corneal trephines of the appropriate size. The scar formed after the healing of the corneal wound.
II. In the second group two concentric incision were made. After making the first incision as in the previous group, a second incision was made with a one milimeter smaller Franceschetti's corneal trephine inside the first incision to a similar depth of 0.60 milimeter.
III. In the third group, after making the two concentric corneal incisions similar to the second group, the intervening corneal tissue in the anterior 0.50 milimeter was removed and the wound allowed to heal.
The operative procedures in the present study are simple and safe. In all the twenty one cases the corneal trephine incisions healed without complication and in most of the cases the eyes had become quiet in two weeks time except in one case where the inflammation persisted for five weeks. The changes in the radius of cornea and the reduction in myopia after 8 weeks of surgery in the 3 groups have been summarised in [Table - 1],[Table - 2] respectively.
In the first group of the nine cases of single scarring, the corneal curvatures were reduced by 0.10 to 0.19 mm in five cases and by 0.20 to 0.29 mm in three cases. In one case the reduction was between 0.30 to 0.39 mm. whereas in the second group of double scarring the reduction in the corneal curvatures was between 0.50 to 1.90 mm and in the third group of double scarring with keratectomy the reduction in the corneal curvatures between the 0.50 to 1.90 mm.
One single corneal scar was able to reduce the myopia by-01.00 D to.1.50D in six cases and-1.50 to-200D in three out of the nine cases; whereas the double scar could reduce the myopia by-1.50D to-2.00D in two cases and-2.00D to-2.50 in three cases, and-2.50D to-3-00D in two out of seven cases. In the third group the results are almost identical to the second group.
In all the three groups the corneal scars have produced a reduction in the corneal curvatures and myopia. This reduction in the corneal curvature is least in the single scar, whereas it is more in the double scar with or without keratectomy. The changes produced are the same in the second and third group of cases and the excision of the anterior or intervening corneal tissue appears to have made no appreciable difference, probably because of very narrow gap between the two scars. The reduction in myopia seems to be due to change in corneal curvature.
| Conclusion|| |
The authors are of the opinion that a simple corneal scar at the periphery of the cornea provided a safe, easy and cosmetically acceptable surgical correction of myopia. And probably a wider scar may produce higher correction in the myopes.
| Summary|| |
Peripheral corneal scarring was produced by various methods in twenty one myopes, which resulted in the reduction of the corneal curvatures and the corresponding decrease in the myopia. The best results were obtained by producing a double corneal scar with a trephine, which could correct the myopia upto-3.OOD.
[Table - 1], [Table - 2]