• How is corneal scraping surgery performed?


    Question:

    I had a few questions about corneal scraping. How is it performed and is a local or general anesthetic used during the operation? I also wondered if a bandage contact lens is required after and how much pain is to be expected. Are most patients given a prescription painkiller after surgery or just Tylenol?


    Answer:

    A superficial keratectomy is a procedure to remove diseased cells on the surface of the cornea. It can be performed in the office or in the operating room and usually takes 15-30 minutes.

    There are many ways to perform a superficial keratectomy. First, anesthesia is used to numb the surface of the eye. In addition to topical anesthetic, some ophthalmologists also prefer intravenous sedation (medicine given by injection in the arm or hand to help you relax and to block pain) or oral sedative to aid in pain control. Alcohol is sometimes applied to loosen the attachment of the surface cells from the rest of the cornea. The diseased cells are then removed with a blade or brush. Occasionally another instrument is used to polish the surface of the cornea. A bandage contact lens is placed to cover the wound, followed by topical antibiotics.

    Since a corneal abrasion (scratch or scrape on the front of the eye) is created when the surface cells are removed, the recovery can be pretty painful. The bandage contact lens helps because it covers the exposed corneal nerve endings, but patients can still experience severe pain. Depending on the level of pain, the ophthalmologist may recommend artificial tears, a topical NSAID (nonsteroidal anti-inflammatory drugs), Tylenol, or narcotics (prescription pain relievers). When I perform the procedure, I always place a bandage contact lens and tell patients to take Tylenol. If the pain is still severe, then I prescribe a narcotic medication. Talk to your ophthalmologist to see what he/she prefers for you.


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