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Looking for emmetropia in a patient with keratoconus

Poster Details

First Author: A.Valero Marcos SPAIN

Co Author(s):    J. Fernández Pérez   J. Jiménez Velázquez   F. Martínez Peña        

Abstract Details



Purpose:

Keratoconus is a corneal degeneration which hasn´t a strong hereditary. The association with pathologies such as allergic conjunctivitis, atopy, etc. which has a marked tendency of the patient to chronic rubbing of the eyes, seems to be behind the aggravation of this situation. Currently, the corneal topography has to be diagnosed in the earlier stages each. This fact, with the emergence of new treatments for control (intracorneal rings, cross -linking) have made that we are in the most hopeful time for all patients suffering from this disease.

Setting:

Department of Ophthalmology, Q Vision, Vithas Vírgen del Mar Hospital, Almería (Spain).

Methods:

A 52 years patient is attended in our clinic for evaluation of possibility of improved visual acuity by refractive surgery. He says about amblyopia of the right eye. On examination, the best corrected visual acuity was 0.2 in the right eye (RE) and 0.9 in the left eye (LE). The exploration showed a temporary inferior corneal thinning in the right eye. Topography showed a grade III keratoconus and a high comatic aberration in RE and a normal LE was performed. Adaptation of scleral contact lens is proposed to assess likely to improve visual aberrations in RE, reaching 0.8 of view.

Results:

With this visual improvement, discarding deep amblyopia, an intrastromal implant segment type Keraring 6mm, 150 º arc and 250 microns was indicated. After RE surgery, we got a best corrected visual acuity of 0.7 with a considerable reduction of the aberrations and corneal astigmatism. The patient insisted about refractive surgery, so after 8 months topographically stable, a monofocal toric lens was indicated in both eyes, resulting in a visual acuity of 0.9. Glasses for near were prescribed.

Conclusions:

The correct diagnosis and implantation of intrastromal ring provides the stability of keratoconus but also a good refractive outcome. Check vision with rigid gas permeable contact lens can help to rule out amblyopia. The combination with an intraocular refractive surgery is an option that should be studied in some cases. FINANCIAL INTEREST: NONE

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