Posters

Choosing the strategy of visual function improvement in RK patients using Scheimpflug tomography and classification of corneal incision healing types

Poster Details

First Author: E.Branchevskaya RUSSIA

Co Author(s):    S. Branchevsky                    

Abstract Details

Purpose:

To describe three clinical cases of various treatments combinations for visual functions improvement in RK patients.

Setting:

Branchevsky Eye Clinic, Samara, Russian Federation

Methods:

Oculyzer (Alcon, USA) was used for estimation cornea parameters. First clinical case represents results of binocular phacoemulsification with extended depth of focus IOL implantation in RK patient. Holladay EKR report graph showed a high peak and smooth optical zone. The second case represents results of binocular aspheric IOL implantation and transepithelial topo-guided PRK targeted to monovision in RK patient with severe corneal irregularity. The third clinical case represents results of phacoemulsification with aspheric IOL implantation and RGP scleral lens for RK patient with hyperopic shift and severe irregular astigmatism. ASRS IOL calculator was used to calculate IOL power.

Results:

In the first clinical case 1month after Lentis Comfort LS-313 MF IOL (Oculentis GmbH, Germany) implantation UDVA OU was 20/20 and UNVA OU was 20/32. In the second case, topography-guided PRK was performed 3 months after Carl Zeiss CT Asphina 509M IOL (Carl Zeiss, Germany) implantation.  6months after PRK UDVA OD was 20/20 and UDVA and CDVA OS were 20\32 with manifest refraction Sph -1.5 =20/20. In the third clinical case, significant corneal flattening, as well as an increase of topographic cylinder from 10.0D to 11.5D was noted after phacoemulsification. CDVA after RGP scleral lens fitting was 20\20.

Conclusions:

Depending on Holladay EKR report parameters and corneal incisions morphology different approach might be considered in visual functions improvement of RK patients. In cases with low cornea irregularity, high peak at Holladay EKR report implantation of extended depth of focus IOL might be considered. In case of high irregularity and stable cornea two-step procedure: phacoemulsification with aspheric IOL target for myopia and topography-guided PRK could be used. For RK eyes with unstable corneas after phacoemulsification non-surgical procedures such as scleral lens fitting should be chosen.

Financial Disclosure:

None