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First Author: E.Mai TAIWAN
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To report a customized sequential treatment profile in a highly aberated eye.
National teaching hospital
Retrospective case report in refractive center. A 19 year old male, his right eye sustain trauma by projectile plastic tube with cornea erosion during work, he visited LMD and was given topical medication and SCL, the wound become infected and was refer to our clinic. After routine treatment for the corneal ulcer, his cornea infection subsided but a deep and centrally located cornea scar developed. Anterior segment OCT performed show a deep opacity up to 278um, The scar measuring about 1*2mm lay directly above the pupil zone, causing significant blockage to his vision and left visual field.
Sequential procedure was planned and discussed with the patient and his family. Due to the deep laying scar tissue, a single PTK procedure will take away too much of his cornea tissue and produce insufferable hyperopic refraction and irregular astigmatism. Therefore, a 1st PTK procedure plus free hand excision will remove all of the scar tissue. Then after recovery of some thickness and smoothness of the cornea, a 2nd wavefront guided procedure to correct the remaining highly aberated cornea will produce optimal refractive results. With Patient and his familys consents, the procedures where done. Severe cornea haze was encounter after the 1st PTK, therefore, mitomycin C and high dose steroid was used in the second procedure. Cornea Ant. Segment OCT, cornea external photos, Wave front profile and treatment profile at each procedure will be presented.
Highly aberated eye with irregular astigmatism and deep opacity are treatable with customized wavefront-guided procedure with recent innovative custome ablation profile.