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Complex ocular surface reconstruction

Reconstrucció complexa de la superfície ocular a Vall d'Hebron

Patients have very serious damage to the ocular surface (the cornea, conjunctiva and eyelids) generally caused by chemical burns or an inflammatory disease of the ocular surface such as cicatricial pemphigoid or Lyell’s syndrome.


These disorders of the ocular surface may result in very low visual acuity, irritation and pain. They are conditions significantly affecting the cornea, the conjunctiva and the eyelids; organs essential to maintaining a healthy ocular surface and therefore good vision.




Loss of vision, pain, severe dry eye syndrome, corneal damage and ulcers, infections, and even loss of the eyeball.




Diagnosis is essentially clinical. Changes in the ocular surface may present as corneal ulcers, corneal vascularization or conjunctivalization (normally the cornea tissue has no blood vessels) or due to symblepharon, which are scars that form between the conjunctiva and the eyelids.


Typical treatment


Treatments are multiple and spread out, depending on how severely the ocular surface is affected. Natural tear substitutes are used, such as autologous serum or plasma rich in platelets. Surgical options that may be carried out are amniotic membrane grafts, corneal transplants, limbal stem cell transplant (autologous or heterogeneous), eyelid transplant, and in very severe cases, keratoprosthesis.




There is no way to prevent this serious condition of the ocular surface, but early diagnosis and treatment can limit the damage it causes.





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