Corneal scars can often result from an accident or an infection. Corneal infections can be caused not only by bacteria or fungi, but also viruses or parasites. These pathogens migrate into the transparent cornea and cause all of these problems. Although the pathogens can often be eliminated, the damage in the cornea has already been made, and the scar, depending on its location, can severely impair people’s visual acuity. In fact, visual impairment due to corneal scarring is one of the major causes of blindness worldwide.
Corneal scars can do two things:
We have a number of ways to reduce the effects of corneal scarring. Our motto is that it is always best to maintain your own cornea, and that corneal transplantation is only the option of last resort. With that in mind, if the excimer laser can be used to improve the cornea to the extent that good vision is possible, then this is always the best choice. Lasering is often carried out in two stages: in a first step, what’s called phototherapeutic keratectomy (PTK) is performed, which is primarily intended to reduce the opaqueness of the scarred part of the cornea. If a part of the scar is then removed, then the cornea will relax over the next few months, reducing the irregular corneal curvature over the next 4–6 months
A 19-year-old patient who showed a corneal scar after fungal infection. The scar caused both a cloudiness and a very irregular cornea. The best corrected visual acuity was 40%. After reconstructive laser surgery, the vision was 80% and the cornea was much more symmetrical.