Case Reports

Presbyopia inlay extrusion, through early cornea melt: Surgical revision and 9 year management of a potentially vision-threatening complication

Case Report Details

First Author: V.Moustou GREECE

Co Author(s):    A. Kanellopoulos                    

Abstract Details

Purpose:

To report an early, serious complication, of corneal stromal melt and inlay extrusion along with surgical and medical management and eventual visual rehabilitation over 9 years.

Setting:

LaserVision.gr Clinica and Research Eye Institute

Report of Case:

A 55 year-old hyperopic male underwent uneventful topography-guided, femtosecond laser-assisted hyperopic LASIK, combined with same day polymer refractive-inlay implantation in the non-dominant eye for presbyopia treatment. The early post-operative visual acuity and refractive data, removal 2 months later following anterior stromal melt and extrusion, long term medical management and visual rehabilitation, along with extensive anterior segment imaging over 9 years was evaluated. The initial cornea irregularity of 10 diopters central flattening and drop of CDVA to 20/80 from 20/20, gradually improved over 9 years to result in anear-normal corneal curvature and CDVA improvement to 20/20, UDVA 20/20-. Anterior segment imaging confirmed the initial LASIK flap button-hole, filled-in by progressive epithelial remodeling. Initial dense scarring improvement initially on corticosteroids and gradually without treatment to an eventual clinically-insignificant level.

Conclusion/Take Home Message:

Intra-corneal refractive synthetic inlays, may result in severe potential complications. Patient compliance with assessment, medical and when necessary surgical management, along with caution for early signs of corneal melt are findings that are reported.

Financial Disclosure:

None