Cataract
Since he was a trainee doctor, when Ewan Craig published his first paper on the subject of cataract surgery, he has always been interested in improving the processes and outcomes of cataract surgery. In all patients where there is a significant amount of astigmatism he routinely carries out a small additional procedure to correct this as part of cataract surgery. To maximise the chance of good vision without glasses he uses a number of different ways of calculating the refractive (focusing) outcome of cataract surgery.
In 2007 he began carrying out Micro-Incision Cataract surgery, allowing the cataract to be removed and the new lens to be inserted through an incision only 1.5mm across (about half the standard wound size used in the UK). This evolution of the now standard technique of phacoemulsification allows patients to return to completely normal activities immediately after surgery, avoiding the need for any restriction of activity or need to wear an eye shield afterwards.
In patients who wish to maximise their ability to see without glasses, and who are suitable for the procedure, he implants the Crystalens the latest Accommodating Intraocular lens from Bausch and Lomb (not currently available in the NHS).
Ewan Craig was one of the first UK surgeons to implant the Bausch and Lomb Micro-Incision Intraocular lens when it was introduced. He has used this lens extensively in both NHS and Private Practice as his “single focus” lens of choice since then and is now the UK’s most experienced user of the lens. (Manufacturer’s Data)
Cornea
Having carried out lamellar corneal transplantation for some 14 years Ewan Craig has constantly updated his surgical techniques to ensure that his patients always benefit from the latest and most effective operations. One of the UK’s first corneal surgeons to begin posterior lamellar keratoplasty (PLK) in 2002, he progressed to carrying out Descemet’s Stripping Endothelial Keratoplasty (DSEK) in 2004 and was very encouraged by the results.
When Gerrit Melles, the world-leading pioneer of lamellar corneal surgery from Rotterdam demonstrated a patient on whom he had performed the newest technique of Descemet’s Membrane Endothelial Keratoplasty (DMEK) to a meeting of UK Corneal surgeons in 2008 Ewan Craig was astounded at the result. A trip to Rotterdam six weeks later to see Melles operate and to view the results of yet more operations convinced him that this new operation was another significant step forward.
Ewan Craig performed his first DMEK in July 2008. One week later the patient could see well enough with the operated eye to drive and could read the very bottom line on the test chart (6/5) within three months of the operation.
Since then DMEK has been his first choice procedure for all suitable patients. The visual outcomes of his patients having DMEK have proved to be significantly better in his hands than those who had the older DSEK operation and enormously better than those who had full thickness corneal transplantation (penetrating keratoplasty). The results of DMEK have proved to be particularly good in patients with Fuch’s Corneal Endothelial Dystrophy.
In addition to DMEK and, in cases where DMEK is not possible, DSEK, Ewan Craig also performs full thickness or penetrating keratoplasty (PK) for patients with corneal scarring and endothelial disease and Deep Anterior Lamellar Keratoplasty (DALK) for patients with keratoconus or corneal scarring without endothelial disease.
Glaucoma
Ewan Craig performs surgery for glaucoma, including trabeculectomy with and without augmentation with antimetabolites (anti-scarring drugs) and laser procedures for glaucoma control.