Eye operations are considered as therapy if visual aids and eye medicines can no longer help to improve the symptoms. They are therefore regarded as a last resort to alleviate a visual impairment or to cure a serious eye disease. The most common eye operation currently performed is cataract surgery, which is performed in Germany about 600,000 times a year. Surgical ophthalmology is now moving in the direction of more sophisticated and gentle methods. Thus a high-precision laser will increasingly replace the scalpel in the future.
The so-called ECCE operation stands for extracapsular cataract extraction. Here the clouded lens is replaced by an artificial lens. In this eye surgery, the surgeon makes a small incision at the edge of the cornea.
Through this incision, micro-pliers are inserted into the anterior chamber of the eye and a hole is cut in the anterior lens capsule. Using ultrasound (phacoemulsification), the clouded lens core is liquefied, rather than being aspirated by the surgeon through a cannula. The artificial lens then required is then fitted into the hollowed capsule of the eye. By leaving part of the lens capsule in place, it is possible to prevent the vitreous body from falling forward, which can be a complication when replacing the lens completely.
When squinting, the eyeballs are in a wrong visual axis, so that double vision and other visual impairments can occur. This malposition can usually be corrected by surgery: The muscle that pulls the eyeball in the opposite direction to the direction of strabismus is shortened during this eye operation, so that the pulling force is increased and the eyeball is stabilized in the physiological visual axis. In some cases, over- or undercorrection may occur, so that a new operation becomes necessary.
If the pathologically increased intraocular pressure (glaucoma) cannot be controlled with medication, the vision of the affected eye can only be maintained through eye surgery. In this so-called “filtering intervention”, the excess aqueous humor is drained through an artificial opening in the sclera. Through this operation the intraocular pressure is permanently reduced. Another option in glaucoma is laser surgery (argon laser trabeculoplasty), which, however, only improves the outflow of aqueous humor in 50% of patients and only lasts for about two years.
Around holes or cracks in the retina, it can become detached. Ring-shaped freezing stimuli (with a so-called cryoprobe) or burns (with a laser) can cause fixation of the retina to the choroid through subsequent scarring. If there is a large-scale retinal detachment, it can be treated by temporarily denting the eyeball.
For this purpose, the eyeball is constricted with cerclage (silicone band) or a silicone foam seal is sewn onto the sclera of the eye from the outside. Due to this indentation, the retina rests on its pigment layer and can grow with it. Under certain circumstances, the vitreous body may have to be partially or completely removed by suction in the case of a retinal detachment, because if it shrinks too quickly and thus pulls on the retina, it can tear and thus lead to blindness.
The interior of the eye can be filled with heavy liquids such as silicone oil, so that the retina is pressed against the pigment layer from the inside. If there is irreparable scarring or injury to the cornea, the cornea of the eye must be replaced to restore vision. For this purpose, the cornea is removed from deceased organ donors and then transplanted into the affected patient. This operation is also known as keratoplasty.