The vast majority of transplantation operations performed by Mr James Myerscough are of the ‘lamellar keratoplasty’ type, rather than of the traditional, ‘full thickness penetrating keratoplasty’ type. ‘Lamellar keratoplasty’ basically means that rather than needing to replace the entire cornea, only the damaged layer is selectively removed and replaced. This results in a much lower risk of some of the most serious complications such as graft rejection, and has superior visual outcomes. Broadly speaking, lamellar surgery divides the cornea into an anterior (front) lamella, and a posterior (back) lamella.
Common diseases affecting the anterior lamella are Keratoconus, Scars from infections such as the Herpes virus, Stromal dystrophies, and Trauma. Common diseases affecting the posterior lamella are Fuchs endothelial dystrophy, and pseudophakic bullous keratopathy, where the cornea becomes swollen and cloudy after previous intraocular surgery such as cataract surgery.
Particularly with regards to posterior lamellar surgery, the recovery times are far shorter than with conventional full thickness keratoplasty because of the modern sutureless or near sutureless techniques employed by James.
James's academic interests lie in improving visual outcomes following modern techniques of corneal transplantation. He trained in one of the most prestigious corneal graft centres in the world with Professor Massimo Busin in Italy. James regularly teaches these techniques to surgeons around Europe via the European Society of Cataract and Refractive Surgery and, for this reason, you will find the latest techniques available in his hands.
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