Superficial Keratectomy (SK)
The cornea is a transparent structure that covers the front part of the eye and is responsible for focusing light. It is crucial for the cornea to remain clear, otherwise light can be scattered or blocked, which leads to blurry vision.
Superficial keratectomy (SK) is a procedure to remove scarring and opacities in the superficial cornea. The cornea has 5 different layers: Epithelium, Bowman’s membrane, Stroma, Descemet’s membrane and Endothelium.
Common conditions that may require treatment with SK include:
- Epithelial Basement Membrane Dystrophy
- Recurrent Corneal Erosion Syndrome
- Salzmann’s Nodular degeneration( corneal superficial nodules)
- Superficial corneal scar
- Removal of Band Keratopathy( Calcium Deposits)
SK can be performed mechanically or with a laser (phototherapeutic keratectomy —PTK). Your eye surgeon will advise on which procedure is required. Usually PTK is used to remove scars in the anterior stromal layer of the cornea.
What is the SK procedure?
The SK procedure is an outpatient procedure performed either in the office or in the hospital. Anaesthetic drops are used to make the eye comfortable. The superficial layers of the cornea are scraped and then polished to remove the opacities. Sometimes medications are applied to remove calcium (EDTA) or to prevent scar formation (mitomycin C). A bandage contact lens is placed on the eye to reduce pain after the procedure and to help with healing.
Antibiotic and anti-inflammatory eye drops are often prescribed for about one week and the bandage contact lens may be left in until your surgeons advises it is ready to be removed. Rarely patients may experience a small change in the prescription of their glasses after the procedure.
What should I expect after SK?
After the procedure you are safe to resume normal activities but should avoid rubbing the eye. Initially expect your vision to be blurry and the eye to have sharp pain and tearing. This should slowly resolve over the course of a few days. You may want to be able to take a week off work if this recovery will interfere with your work activities. You should not drive until you feel your vision has recovered.
What are the risks of SK?
The SK procedure is a commonly performed and safe procedure. The main risks relate to differences in healing between patients. It is normal for the eye to have sharp pain, tearing, light sensitivity and blurry vision in the week after surgery. In patients with healing difficulties, this period can be longer and rarely healing can be an issue that requires further treatment. Patients with severe healing difficulties are at risk of corneal melts or perforations, an extremely rare problem.