What are Anterior Segment Procedures?
The anterior segment of the eye can be damaged by trauma or sometimes during surgery for other problems like glaucoma or cataracts. Repairing these problems is within a very specialized range of procedures only offered by a few surgeons in the Shreveport – Bossier City area.
Anterior segment reconstruction is the medical name for a set of specialized techniques that are used to repair damage to the pupil or the iris of the eye. These procedures are most effective when they are performed in conjunction with a corneal transplantation procedure. If performed this way, anterior segment reconstruction can prove to be a very effective and low-risk method to treat severe ocular trauma or the complications associated with a failed surgery, disease, or eye injury.
How is an Anterior Segment Procedure Performed?
Anterior segment reconstruction procedures may involve the stripping of corneal pannus, removal of lens and vitreous remnants, iris and angle reconstruction, intraocular lens implantation, implantation of an artificial iris and/or penetrating keratoplasty.
- A 2 mm incision is made near the limbus in the cornea.
- The anterior chamber is then filled with viscoelastic, but without overfilling.
- The ciliary sulcus space is expanded with the viscoelastic in order to create space between the lens and the iris.
- An anterior chamber maintainer using balanced salt solution may be used to keep the eye pressurized.
- The endoscope tip is focused and rotated by adjusting the camera probe to where it enters the laser console.
- The tip is inserted into the anterior chamber until it reaches the pupillary margin.
- The endoscope is then moved near the ciliary sulcus until 6 to 8 ciliary processes become visible.
- The laser is then centered over one of these processes, and the laser is activated.
- The ciliary process will shrink and whiten when treated properly.
- The aiming beam is then centered on the adjacent process and so on until the probe has reached its full range.
- When the procedure is halfway complete, the probe is rotated 180 degrees and the process is then repeated on the other side.
- Care must then be taken to fully remove viscoelastic, either by automated or manual irrigation and aspiration, or by flushing the anterior chamber and sulcus with an aqueous salt solution while bending the corneal incision allowing the pressured liquids to exit.