Radial keratotomy: a refractive challenge 20 years later

Session Details

Session Title: Presented Poster Session: Refractive Surgery Complications

Session Date/Time: Monday 07/09/2015 | 09:30-11:00

Paper Time: 10:10

Venue: Poster Village: Pod 3

First Author: : I.Almeida PORTUGAL

Co Author(s): :    C. Lisa   J. Chibante Pedro   J. Alfonso        

Abstract Details

Purpose:

Before the introduction of excimer laser technology, radial keratotomy (RK) was the most common refractive surgery for correction of myopia; in this procedure radial incisions flex the peripheral cornea, leading to a compensatory flattening of the central cornea. However it´s associated with some complications including the achievement of emmetropia. Because of that a second surgery is usually necessary. We present a challenging case 20 years later.

Setting:

Instituto Oftalmologico Fernandez Vega

Methods:

Clinical case description

Results:

A 52year old female complained of decreased bilateral visual acuity. She had undergone RK surgery followed by LASIK 10 years later. Currently she presented BCVA 8/10 RE and 5/10 LE; slit lamp examination showed 8 radial and 4 arcuate incisions with cortical cataract; fundoscopy was normal. LE topography revealed flat cornea (K average 36.55D; thinnest point pachymetry 395 µm), irregular astigmatism and ectasia. She was submitted to DALK combined with phacoemulsification with monofocal intraocular lens implantation in the posterior chamber. 15 months after BCVA LE was 8/10 (-3,50x165°); she was submitted to LASIK; 2 months after BCVA was 9/10 (-0.25).

Conclusions:

Patients treated with RK are nowadays a refractive challenge. Several studies have shown LASIK has an option to correct residual refractive errors; In case of irregular astigmatism with/or ectasia, DALK is better than penetrating keratoplasty although the risk of intraoperative corneal perforation; the refractive goal of cataract surgery is hard to obtain because of the difficult biometry after several corneal procedures. This case presents an excellent refractive result with combined procedures.

Financial Interest:

NONE