Oculoplastics
| Procedure Name | Common Indications | How it’s done |
| Ptosis repair | Superior visual field loss; cosmetic improvement | Lots of different techniques, but generally can be done by tightening the muscles that lift the eyelid from in front of (levator) or behind (muller) the eyelid |
| Blepharoplasty | Excess eyelid skin (dermatochalasis) causing superior visual field defect; cosmetic improvement | The excess skin is excised from the eyelid |
| Entropion repair | Eyelids turning inwards can worsen dry eye, cause discomfort, or cause scarring of cornea | Sutures are placed to evert the eyelid or skin is removed to cause eversion of the lid |
| Ectropion repair | Eyelids turning outwards can worsen dry eye and cause discomfort | Lid is tightened laterally to prevent outward rotation |
| Canthopexy | Too much ocular surface exposure (can cause dry eye), cosmetic improvement | Canthal tendon tightening procedure that is performed with a stitch |
| Canthoplasty | Too much ocular surface exposure (can cause dry eye), cosmetic improvement | Lateral canthal reconstruction |
| Canthotomy/cantholysis | Orbital compartment syndrome (e.g. retrobulbar hematoma) | Cut 1-2 cm skin at the corner of eye, cut the inferior crux of lateral canthal tendon |
| Tarsorrhaphy | Too much ocular surface exposure (can cause dry eye), persistent epithelial defect of the eye | Suture upper and lower lid margins together. Could be partial closure (central aperture for viewing) or complete closure. |
| Evisceration | Severe infection or pain in eye with loss of vision | Removal of inner eye contents, (leaving the sclera / muscles intact) |
| Enucleation | Tumors contained within the eye, trauma | Removal of entire globe (leaving muscles intact) |
| Exenteration | Tumors spreading outside of the eye, trauma | Removal of entire globe, muscles, and contents of orbital cone |
| Nasolacrimal Duct Probing | Nasolacrimal duct obstruction (NLDO) leading to overflow tearing | A probe is passed from the eyelid puncta, through the cannaliculus and lacrimal sac, and ending in the inferior turbinate of the nose to open up any a blockage of tear outflow from the eye. |
Cornea
| Procedure Name | Common Indications | How it’s done |
| Deep Anterior Lamellar Keratoplasty (DALK) | Corneal scar, keratoconus | Removal of the anterior cornea, leaving posterior endothelium intact |
| Penetrating Keratoplasty (PK) | Corneal scar, keratoconus, Fuchs corneal dystrophy | Removal of a full thickness circular button of host cornea. Subsequent placement and fixation of donor cornea with sutures |
| Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) | Fuchs corneal dystrophy, pseudophakic bullous keratopathy | Removal of the Descement membrane and endothelium, leaving the anterior cornea intact. Subsequent transplantation of donor Descement membrane and corneal endothelium WITH partial thickness button of donor corneal stroma. |
| Descemet Membrane Endothelial Keratoplasty (DMEK) | Fuchs corneal dystrophy, pseudophakic bullous keratopathy | Removal of the Descement membrane and endothelium, leaving the anterior cornea intact. Subsequent transplantation of donor Descement membrane and corneal endothelium WITHOUT any donor corneal stroma. |
| Keratoprosthesis (KPro) | Failed corneal transplants, corneal conjunctivalization | Removal of a full thickness circular button of host cornea. Artificial cornea fixated onto donor button, and sewn into place on host |
| Corneal Inlays | Keratoconus, corneal weakening (ectasia) | Clear rigid structural supports slid into laser cut grooves in cornea (intrastromal) |
| Photo Therapeutic Keratectomy (PTK) | Superficial corneal opacities / irregularities, some corneal dystrophies | Laser removal of superficial corneal opacities / irregularities |
| Cross-Linking (CxL) | Keratoconus, corneal weakening (ectasia) | Application of riboflavin, followed by laser activation to strengthen cornea |
Refractive Surgery
| Procedure Name | Common Indications | How it’s done |
| Astigmatic Keratotomy (AK) / Limbal Relaxing Incision (LRI) | Astigmatism | Blade or laser used to create 80-90% thickness incisions to flatten cornea and reduce astigmatism |
| Laser Assisted in situ Keratomileusis (LASIK) | Refractive error | Hinged corneal flap is cut and lifted. Laser shapes the cornea to reduce refractive error. Corneal flap replaced, faster recovery than PRK but possible flap complications. |
| Photorefractive Keratectomy (PRK) | Refractive error | Corneal epithelium removed, laser shapes the cornea to reduce refractive error. No flap complications, but epithelium must regrow, leading to a more painful, slower recovery than LASIK. |
| Radial Keratotomy (RK) | Refractive error | Grooves cut radially in cornea cause steepening, correcting myopia. This older technique is rarely used today. |
Glaucoma
| Procedure Name | Common Indications | How it’s done |
| Trabeculectomy (trab) | High intraocular pressure not controlled by other measures (drops, laser, etc.) | A partial thickness flap is created in the sclera and a hole is made into the anterior chamber. The flap is then sutured down to better control the outflow so the eye doesn’t completely depressurize. |
| Ahmed / Baerveldt Valve (tube) | High intraocular pressure not controlled by other measures (drops, laser, etc.) | A tube is inserted into the anterior chamber, fluid drains from this tube into the subconjunctival space |
| Iridotomy / Iridectomy | Narrow angle glaucoma | Removal of part of the iris (by laser or surgery) |
| Trabeculotomy | Pediatric glaucoma when corneal opacity limits view. | Opening of schlemm’s canal via an external approach (cannulation of schlemm’s canal and purse string tearing inwards to open the canal and improve outflow) |
| Goniotomy | Pediatric glaucoma, when cornea is clear | Opening of the schlemm’s canal via an internal approach (direct incision) |
Retina
| Procedure Name | Common Indications | How it’s done |
| Pars Plana Vitrectomy (PPV) | The workhorse retinal procedure, used to operate inside the eye (epiretinal membrane, vitreomacular traction, macular hole, vitreous hemorrhage, rhegmatogenous retinal detachment, tractional retinal detachment, endophthalmitis and retained lens fragments) | Instruments inserted into the eye include light pipe, vitreous cutter, and infusion line. Other intraocular instruments can be used to cut, grasp, laser or put gas into the eye. |
| Membrane Peel | Epiretinal membrane | During PPV, instruments are used to remove the preretinal membrane |
| Endolaser | Vitreous hemorrhage | During PPV, a laser is introduced into the eye to photocoagulate the retina |
| Air-fluid Exchange or Silicone Oil | Retinal detachment repair, macular hole repair | During PPV, fluid is exchanged for air, gas or silicone oil to provide tamponade for the retina |
| Scleral Buckle (SB) | Retinal detachment | An encircling band is placed around the eye to bring the walls of the eye inward. Cryotherapy and drainage of subretinal fluid are used in conjunction with scleral buckling. |
| Pneumatic Retinopexy | Retinal detachment | An intraocular gas bubble is injected to seal the retinal break while cryotherapy creates chorioretinal scarring to permanently seal the break. |
Eye Muscles
| Procedure Name | Common Indications | How it’s done |
| Strabismus Surgery | Misalignment of the eyes (strabismus) | Eye muscles are detached, cut, and/or reattached to the eye to strengthen or weaken the the muscle to improve eye alignment |
Lasers
| Procedure Name | Common Indications | How it’s done |
| Panretinal Photocoagulation (PRP) | Proliferative diabetic retinopathy | Lasering the ischemic retinal periphery to prevent neovascularization |
| Laser Retinopexy | Retinal tears | Lasering around a retinal tear to prevent progression to a detachment |
| YAG Capsulotomy | Posterior capsular opacification (PCO) | Uses YAG laser to clear opacification of the posterior capsule after cataract surgery |
| YAG Iridotomy | Narrow angle glaucoma | Uses YAG laser to create a hole in the iris to prevent pupillary block |
| Selective Laser Trabeculoplasty (SLT) | High pressure in glaucoma | Application of laser to trabecular meshwork to cause remodeling and decrease IOP |
