Corneal and Anterior Segment Surgery

As well as performing vision correction surgery, Dr Logan at the Wellington Eye Centre performs other surgery on the front of the eye, particularly pterygium surgery and corneal graft surgery

Pterygium Surgery:

A pterygium is a growth of thickened tissue that develops on the white part of the eye, usually on the nose side of the eye, and can extend onto the surface of the cornea towards the pupil. Both eyes can be affected.

If a pterygium grows large enough it can affect the vision or cause other symptoms such as redness and irritations. If this happens, the pterygium may need to be surgically removed. If a pterygium is not interfering with sight or causing annoying symptoms, it can safely be left alone.

A pterygium is not a skin cancer and usually grows relatively slowly.

Causes of a Pterygium

A pterygium is almost certainly caused by exposure to excessive amounts of ultraviolet light or to dry, dusty atmospheres. They are very common in Australasia and are more common in people who spend a lot of time outdoors.

PINGUECULA: A pinguecula (pin-gwek'- u-lah) is yellowish lump which develops on the white of the eye. It can be surgically removed in the same way as a pterygium, but this is rarely necessary.

Reasons for Removal of a pterygium

Not all pterygia need to be removed. They may be removed in the following cases.

If vision is threatened - If a pterygium grows large it can block or blur vision and it may even block the pupil. If the pterygium is too large, permanent scarring may be left after it is removed.

Grittiness, discomfort and redness - A pterygium can cause considerable grittiness and redness. This may be temporarily eased with eye drops, but removal may be necessary if drops do not give symptomatic relief.
Astigmatism - A growing pterygium can pull on the cornea causing astigmatism and reduced vision.
Appearance - The pterygium may be removed if it is cosmetically unsightly.
Contact lenses - A pterygium can interfere with the contact lens fitting or the pterygiujm may be irritated by the edge of the lens.

Pterygium Surgery

The operation to remove a pterygium is usually performed using aneasthetic eye drops and takes 20 to 30 minutes.

The pterygium is peeled of the cornea and the scar tissue is removed. This usually leaves a bare area on the white of the eye which is covered by a skin graft taken from under the upper lid. Traditionally the graft has been sutured in place, but the Wellington Eye Centre uses a natural tissue glue called Tisseel™ to stick the graft in place. This results in quicker recovery after the operation with less irritation and discomfort while the eye is healing.

Corneal Graft Surgery

Dr Logan at the WEC is one of the busiest corneal graft surgeons in New Zealand. He is the first surgeon in Australasia to perform a corneal graft technique called DSAEK.

Corneal grafting may be performed to correct poor vision caused by scarring or distortion of the cornea. It may also be performed if the cornea has been damaged by an infection or injury.

Traditionally in corneal grafting, the whole thickness of the cornea has been replaced. This is known as "Penetrating Keratoplasty". This results in quite slow visual recovery, slow healing and astigmatism.

In many cases, only part of the thickness of the cornea needs to be replaced - this is a technique known as "lamellar keratoplasty". This technique can offer faster recovery with less astigmatism, and less risk of the graft being rejected.

Dr Logan is the pioneer of a technique known as DSAEK. In this operation only a thin layer of cells on the back of the cornea is transplanted. This technique offers fast visual recovery in older patients needing a corneal transplant.

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