Posters

Refractive lenticule transplantation (RLT) for correction of iatrogenic hyperopia and high astigmatism after LASIK

Poster Details

First Author: A. Lazaridis GREECE

Co Author(s):    D. Reinstein   T. Archer   W. Sekundo              

Abstract Details

Purpose:

To design a technique for intrastromal transplantation of stromal lenticules with specific refractive power in order to correct post-LASIK induced hyperopia and astigmatism.

Setting:

Department of Ophthalmology, Philipps University of Marburg, Germany

Methods:

A 28 year old patient was referred for consultation after complicated LASIK for moderate myopia and astigmatism. The refractive error of the right eye was severely overcorrected due to a data entry error. Post-LASIK refraction showed very high astigmatism (OD:+6.50/-9.00/84°) and CDVA of 20/32. The corneal thickness was 282µm. Due to contact lens intolerance, poor visual acuity and severe anisometropia a Refractive Lenticule Transplantation was performed. A toric and myopic lenticule, obtained from a donor using the ReLEx® FLEx technique (refractive correction:-4.0/-4.25/14°), was implanted under the flap, in order to reduce the refractive error and restore the corneal volume.

Results:

Six weeks after surgery the donor lenticule was spread smoothly in the interface with a minor temporal decentration in relation to the pupil centre. The refraction showed a reduction of astigmatism as expected, but a stronger myopisation compared to preoperative calculations (OD:-6.50/-4.0/70°). At three months, the CDVA returned to preoperative value of 20/32. One year postoperatively corneal tomography showed no signs of ectasia and biomicroscopy showed no signs of rejection. After an additional implantation toric myopic ICL the patient regained an UDVA of 20/40 and a full stereopsis.

Conclusions:

The Refractive Lenticule Transplantation technique offers a solution for rare cases of post-LASIK hyperopia and high astigmatism while restoring the volume of very thin corneas. Moreover, it is a reversible procedure with low probability of rejection.

Financial Disclosure:

One or more of the authors receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented