KERATOPLASTY VERSUS INTRASTROMAL SEGMENTS IN KERATOCONUS

HUMBERTO ESCORCE CURECHIEF OF DEPARTMENT ANTERIOR SEGMENT

INSTITUTO DE LA VISION - FUNDAVISIÓNBARRANQUILLA, COLOMBIA

THE AUTHORS HAVE NO COMMERCIAL INTEREST, NOR RECEIVE BENEFIT FROM, THE MATERIALS

AND/OR PROCEDURES MENTIONED BELOW.

 PURPOSE

Describe the topographic and visual acuity

changes in a patient with a history of

Keratoconus which performed a penetrating,

keratoplasty and lasik in the left eye versus

a treated with implant of intracorneal

segments in the right eye.

 METHODS

Descriptive study, clinical case, which discussed the case

of a patient with diagnosis of bilateral Keratoconus, in

whose left eye it was first performed a penetrating

keratoplasty and one year later a Lasik . In the right eye

were implanted Ferrara intracorneal segments. Were

taken as the study variables topographic values pre

surgical and postsurgical at 3 mm, 5 mm and 7 mm,

visual acuity pre surgery and post surgery without and

with correction with a 3-year follow-up.

RIGTH LEFT

COMPARISON OF TOPOGRAPHIC VALUES OF KERATOPLASTY AND INTRACORNEAL SEGMENTS FIRST YEAR

COMPARISON OF TOPOGRAPHIC VALUES OF KERATOPLASTY AND INTRACORNEAL SEGMENTS AT 3 YEARS

RIGHT EYE

LEFT EYE

9

PREOPERATIVE POSTSURGlCAL

PREOPERATIVE POSTSURGlCAL

 RESULTS

The preoperative uncorrected visual acuity was 20/400 logMAR (1.30) for both eyes. The preoperative best corrected visual acuity was 20/70 logMAR(0.54) for the right eye, and 20/80 logMAR (0.60) for the left eye. In right eye after intracorneal segment, corrected and uncorrected visual acuity was 20/30 logMAR (0.18). The left eye visual acuity was 20/80 logMAR (0.60) with and without correction posterior to keratoplasty. The lasik eye surgery is performed later obtained a visual acuity 20/50 logMAR (0.40) without correction, and 20/20 logMAR (0.00) with correction.

Topographical changes that occurred, in the right eye in which were placed intracorneal segments was observed greater stability of the topography and a reduction in keratometric values after three years, compared with the left eye who underwent keratoplasty, which presented an increase keratometric values after 3 years

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Jean-Louis Bourges, Thong Than Trong, Pierre Ellies, Benoit Briat, Gilles Renard Journal of Cataract & Refractive Surgery June 2003 (Vol. 29, Issue 6, Pages 1228-1230)

2. Ferrara intracorneal ring segments for keratoconus Sérgio Kwitko, Nórton Souto SeveroJournal of Cataract & Refractive Surgery - April 2004 (Vol. 30, Issue 4, Pages 812-820, DOI: 10.1016/j.jcrs.2003.12.005)

3. Ferrara intracorneal ring implantation and cataract surgery for the correction of pellucid marginal corneal degeneration Leonardo Akaishi, Patrick F. Tzelikis, Irving M. RaberJournal of Cataract & Refractive Surgery - November 2004 (Vol. 30, Issue 11, Pages 2427-2430, DOI: 10.1016/j.jcrs.2004.04.047)

4. Long-term follow-up of intrastromal corneal ring segments in keratoconus Leonardo Torquetti, Rodrigo Fabri Berbel, Paulo FerraraJournal of Cataract & Refractive Surgery - October 2009 (Vol. 35, Issue 10, Pages 1768-1773, DOI: 10.1016/j.jcrs.2009.05.036)

5. Keratitis after intracorneal ring segment insertion for keratoconus James C. McAlister, Navid Ardjomand, Luca Ilari, Lakhbir S. Mengher, David S. GartryJournal of Cataract & Refractive Surgery - April 2006 (Vol. 32, Issue 4, Pages 676-678, DOI: 10.1016/j.jcrs.2005.09.026)