The most significant worldwide advances in corneal surgery to take place in the last forty years

A report from the WHO in 2001 highlighted that diseases affecting the cornea are a major cause of blindness worldwide. Corneal blindness can occur due to lesions affecting the front of the cornea, the back of the cornea or even the middle portion of the cornea also the whole corneal thickness can be affected.

Historically the mainstay of treatment to correct any of these problems has been full-thickness corneal grafts which always result in high levels of astigmatism and mean each patient has a risk of rejection of the transplanted cornea. Refractive surgery has now produced major advances in instrumentation to enable correction of short or long sight. Some of the same instruments have now been adapted to use in transplantation surgery to manage serious corneal problems

Professor Johnny Moore from the Cathedral Eye Clinic, Mater Hospital Belfast and the University of Ulster recently trained in Italy with Dr Massimo Busin who has revolutionized the treatment of these corneal problems.

Professor Moore has now brought this surgery back to Northern Ireland where patients who originally were not offered corneal surgery due to the risk of immunological rejection can now be treated with these revolutionary new surgical techniques. Patients who would have until very recently required full thickness corneal transplantation surgery requiring long periods of recuperation with management of astigmatism and suture removal often continuing beyond 12 months. These patients can have quick painless surgery requiring only local anaesthesia and can have sutures removed after 2-3 weeks.

Patients with front of the corneal problems can have this area selectively replaced, those with only the middle region of the cornea affected can have this central portion of cornea dissected with extreme precision and replaced with donor cornea a form of surgery never available prior to the use of these techniques.

Though this surgery is extremely complex and technically difficult, these are the most significant advances in corneal surgery to take place in the last forty years.