Modern corneal and refractive procedures

Department of Ophthalmology and Visual Sciences, Eye Care Center, University of British Columbia, 2550 Willow Street, Vancouver, BC V5Z 3N9, Canada Department of Ophthalmology, University of Manitoba, Winnipeg, Brandon Regional Health Authority, Brandon, MB, Canada Author for correspondence: [email protected] Recent advances in technology and our understanding of corneal physiology have led to a rapid progression in available corneal and refractive surgical procedures. In contrast to the past, penetrating keratoplasty is no longer the only intervention of choice. Lamellar keratoplasty has gained a renewed interest and newer approaches, such as phototherapeutic keratectomy, laserassisted in situ keratomileusis, intrastromal corneal ring segments, corneal collagen crosslinking, deep anterior lamellar keratoplasty and endothelial keratoplasty, are improving and becoming increasingly popular. This article is intended to be an overview of the modern corneal procedures, divided into three categories: anterior cornea, including those involving the epithelium, Bowman’s layer and anterior stroma; stromal; and posterior cornea, including those involving the posterior stroma, Descemet’s membrane and endothelium. Newer and experimental corneal procedures are also discussed.