Case Reports

Modified cornea suture technique for irregular astigmatism correction after radial keratotomy

Case Report Details

First Author: F.Taguchi BRAZIL

Co Author(s):    O. Naves   W. Nosé                 

Abstract Details

Purpose:

To report the use of a modified corneal suture to improve vision in a post refractive keratotomy (RK) patient with severe irregular astigmatism.

Setting:

Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of Sao Paulo - EPM/UNIFESP, Brazil.

Report of Case:

A 61-year-old woman, who had undergone RK twenty-five years before the present report, developed progressive irregular astigmatism in both eyes. She had lost vision of the left eye due to secondary glaucoma after penetrating keratoplasty. Her main complaint was blurry vision in the right eye even with spectacles. She was intolerant to the use of contact lenses. Her uncorrected distance visual acuity (UDVA) was 20/125 and her best spectacle corrected visual acuity (BSCVA) was 20/80 with +2.00DS -3.75DC x 55º. Her slit lamp examination showed sixteen RK incisions and six arcuate incisions; Placido disc keratoscopy demonstrated irregular astigmatism; and corneal tomography (Pentacam - Oculus Instruments, Wetzlar, Germany) had keratometric readings of 25.0D / 29.0D in central cornea. A modified corneal suture was performed in some of the RK incisions in order to reduce central cornea irregularity. After one month, she had UDVA of 20/40 and BSCVA of 20/30 with -1.50DC x 100º. Placido disc keratoscopy shows improvement of central rings; and corneal tomography had keratometric readings of 29.1D / 30.5D. One year after surgery, the patient still retains 20/40 UDVA and is able to carry out her activities using spectacles only for reading.

Conclusion/Take Home Message:

This modified corneal suture technique offers an alternative to Greene’s lasso sutures and is able to improve vision in post-RK patients who are intolerant to contact lens use.

Financial Disclosure:

None