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Residual ametropia after ametropia correction

Poster Details


First Author: G.Neri Pires PORTUGAL

Co Author(s): A. Vergamota   J. Silva                 

Abstract Details

Purpose:

Currently there are multiple surgical options to maximize previous refractive procedures and/or cataract surgery outcomes, being sulcus implantation lens (SIL) one of them.

Setting:

Hospital dos LusĂ­adas, Lisboa, Portugal

Methods:

Clinical case-report

Results:

The authors report the clinical case of a 77-year-old female seen in a refractive clinic due to left eye (LE) visual acuity decrease as her main complaint. She had previously undergone LASIK correction in another clinic due to a hyperopia of +4,25D in the right eye (RE) and +4,5D in the left eye (LE). After unsuccessful refractive outcome bilateral phacoemulsication was performed (with a SN60WF +22,0D implanted in-the-bag of the right eye (RE) and SN60WF +20,5D implanted in-the-bag of the LE) and an additional procedure for correction of residual ametropia with LIS (Rayner 653T +1,00D(+2,00D) RE and Rayner 653L +2,00D LE) was done.On our first clinical evaluation, the best corrected visual acuity (BCVA) was 6/10 (RE) and 4/10 (LE). Slit-lamp examination revealed the presence of ocular visco dispersive (OVD) material in-the-bag behind the lens of the RE and a misguided orientation of the SIL of the LE that was inducing a narrowing of the anterior chamber. Intra ocular pressure (IOP) was 16/25 mmHg. Fundus examination was unremarkable.After careful evaluation of the patients’ topography, biometry, anterior segment optical coherence tomography and specular microscopy, surgical correction was proposed, obtaining a post-operative BCVA of 10/10 in both eyes and an IOP of 13/10 mmHg.

Conclusions:

SIL allow for residual ametropia correction after refractive procedures. However, adequate pre-operatively assessment and surgical training is warranting to fulfil the desired goals. Due to the lens format an erroneous implantation will lead to anterior chamber narrowing inducing multiple complications, such as a raise in IOP, inflammatory damage and endothelial cell loss, to name a few. In addition, caution must be made when evaluating biometry data from eyes that had previous corneal surgery.The authors report a clinical case were clinical suspicion was crucial for the diagnosis and correct treatment of the refractive error and to prevent irreversible damage to the ocular structures.

Financial Disclosure:

None

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