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Superficial Keratectomy Before Cataract Surgery: When to Consider Corneal Scraping

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Amarpreet Brar, M.D.

Medically Reviewed by Amarpreet Brar, M.D.

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Superficial keratectomy serves as both an elective procedure and as a necessary one. Certain circumstances make it needed for some people who are in line for cataract surgery.

According to researchers writing for Review of Ophthalmology, the following preexisting conditions can call for superficial keratectomy ahead of cataract surgery:

Anterior Basement Membrane Dystrophy

This hallmark of this condition is tiny dots or specks in the cornea. Patients can experience blurred vision or double vision. It sometimes needs to be treated prior to cataract surgery before measurements for the IOL implant can be taken.

Band Keratopathy

Band keratopathy involves a band of calcium deposits across the surface of the cornea. The denser the salt layer, the more it impacts one’s vision. Significant vision loss is possible.

Salzmann’s Nodular Degeneration

All three circumstances have irregularities affecting the preoperative measurements for cataract surgery and the postoperative outcomes. By removing the abnormalities and smoothing the surface of the eye, your doctor ensures that you have the best chance at a successful cataract surgery.

All three circumstances have irregularities affecting the preoperative measurements for cataract surgery and the postoperative outcomes. By removing the abnormalities and smoothing the surface of the eye, your doctor ensures that you have the best chance at a successful cataract surgery.

At the end of an ideal cataract surgery, you will see clearly. To make that happen, you will have the opportunity to choose the type of lens that sits inside your eye. But even with the right lens and the right surgeon, you could struggle with crisp vision after surgery if the surface of your eye is uneven.

Superficial keratectomy is the surgical removal of the eye’s surface tissues. It’s a quick procedure that is typically complete in a few minutes.

What Is the Surgery Like?

Cataract surgery is the replacement of the lens inside your eye. Superficial keratectomy is the removal of layers of tissue on the outside of your eye. Since the inside and the outside of your eye work together to give you clear vision, your doctor might choose to perform both procedures either at the same time or close together.

The American Academy of Ophthalmology says superficial keratectomy is over in 15 to 30 minutes. Your doctor will:

  • Use drops to numb your eyes and possibly give you some sedation.
  • May use alcohol or another agent helps to separate surface tissues from those that lie beneath.
  • Remove the tissue with a blade, brush, or laser.
  • Place a bandage contact lens over the eye as it heals.
man and daughter holding kite

Who Might Want Superficial Keratectomy (Corneal Scraping)?

Some people need superficial keratectomy due to eye health problems, but others might want to consider the procedure to ensure that their cataract surgery goes as smoothly as possible.

For example, some people hope to use a multifocal lens to replace their clouded one. These new lenses have several different spots of focus of varying strengths, and in time, the brain learns to use that varying magnification power. With these lenses, people have a smaller chance of needing glasses or contacts.

These are powerful tools, but they are also very precise. To make sure you have the right strength and power of lens, your doctor must make very delicate measurements of your eyes. Superficial keratectomy can remove minor abnormalities, so your doctor can make the most accurate lens choice for you.

Researchers writing for Ocular Surgery News also point out that superficial keratectomy can improve vision and reduce the need for glasses correction after surgery.

People who dislike risks and want control can benefit from superficial keratectomy, as the results of cataract surgery are just more predictable when the two procedures are combined. Your doctors can help to make the right decision for you.

Frequently Asked Questions

Does superficial keratectomy improve vision?

Superficial keratectomy corrects abnormalities or erosion in the epithelium, the cornea’s outer layer. The procedure smooths the surface of the eye and can improve your ability to make out the details and shapes of objects (visual acuity).

How long is the recovery time from superficial keratectomy?

You may experience blurry vision and swollen red eyes immediately after the surgery, but you should see clearly and be rid of any puffiness within a few days. It takes about six to eight weeks for a full recovery. The doctor will prescribe eye drops for regular application to aid the healing process.

References

  1. How Is Corneal Scraping Surgery Performed? (August 2016). American Academy of Ophthalmology.
  2. Smooth Operator. (October 2013). Review of Ophthalmology.
  3. Optimize Cataract Surgery Outcomes by Addressing Corneal Pathology. (September 2015). Ocular Surgery News.
  4. Superficial Keratectomy: Indications and Outcomes. (December 2018). Canadian Journal of Ophthalmology.
  5. Superficial keratectomy. (March 2015). University of Michigan Health System.
  6. Superficial keratectomy: indications and outcomes. (December 2018). National Library of Medicine.
Amarpreet Brar, M.D.
Medically Reviewed by Amarpreet Brar, M.D.

Dr. Brar has been a board-certified ophthalmologist for more than 15 years, and has performed over 15,000 eye surgeries. He specializes in all-laser Custom LASIK, PRK, cataracts, intraocular lens implants and Wavefront technology.

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