Corneal lasso sutures combined with corneal collagen cross-linking for the correction of progressive hyperopia following radial keratotomy

Session Details

Session Title: Investigations and Complications Management

Session Date/Time: Tuesday 13/09/2016 | 13:30-15:15

Paper Time: 14:38

Venue: Hall C3

First Author: : A.Hajjar SPAIN

Co Author(s): :    J. Duran                    

Abstract Details

Purpose:

To present a new approach in the management of progressive hyperopia with worsening distance visual acuity and/or diurnal visual fluctuations in a series of patients with history of radial keratotomy (RK).

Setting:

Instituto Clínico Quirúrgico de Oftalmología (ICQO), University of the Basque Country, Bilbao, Spain.

Methods:

A case series. Five eyes of four patients with progressive hyperopia and worsening visual acuity following radial keratotomy underwent combined corneal intrastromal lasso suturing (10/0 Mersilene) and corneal collagen cross-linking (CXL) in the same surgery. Riboflavine was applied after blunt reopening of the keratotomies. Uncorrected (UCVA), best corrected visual acuities (BCVA), spherical equivalent refraction, corneal topography were recorded preoperatively and at minimum of 6 months after the procedure.

Results:

Preoperative mean manifest refraction spheric equivalent was +4.188 diopters with average mean UCVA and BCVA of 0.4 and 0.65 respectively on decimal visual acuity (VA) scale. 6 months after the procedure the mean manifest refraction was +0.8125 diopters. UCVA and BCVA were 0.575 and 0.7265 respectively. All patients reported significant reduction in diurnal visual fluctuations. There was one case of mild bacterial keratitis which resolved with topical antibiotic treatment.

Conclusions:

Corneal lasso suturing has been described to treat a hyperopic shift following radial keratotomy. CXL is a well-established procedure for the prevention and management of progressive corneal ectasia and has been used to restore corneal stability after RK. Combination of these two methods may provide an effective, safe and stable technique for correction of hyperopic shift patients with history of RK. Early results in this case series demonstrate significant reduction in the refractive error with marked improvement in UCVA and reduction in diurnal visual fluctuations. Longer follow up is required to validate the stability of the outcomes.

Financial Disclosure:

NONE