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Optical system surgery (DALK+IOL exchange) to treat post-radial keratotomy ectasia

Poster Details

First Author: A.Rodriguez-Raton SPAIN

Co Author(s):    V. Martín   J. Alfonso           

Abstract Details


Radial Keratotomy (RK) used to be a common procedure in which peripheral incisions would reduce central corneal curvature in myopic patients. Emmetropia was achieved for a while but, in the follow up, this procedure has shown to produce an ectatic disorder in a number of patients. Eye optical system resents from this added corneal aberration. We state an integral approach must be made in order not to worsen the situation.


Instituto Oftalmológico Fernández-Vega, Oviedo, España


a 52-year-old male came to our clinic complaining of progressive blurry vision in his OD. He had been operated of RK twice in his 30’s showing 16 cuts. A year ago, a colleague proceeded to clear lens extraction (CLE) and IOL implantation obtaining a refractive surprise. Despite of an IOL exchange and a YAG capsulotomy, uncorrected visual acuity (UCVA) was 0.4 and best-corrected visual acuity (BCVA) was 0.7. We diagnosed a post-refractive keratectasia and proceeded to Deep Anterior Lamelar Keratoplasty (DALK) associated to an IOL exchange in order to re-equilibrate the patient optical system.


one month after the surgery, no complication has been observed and the patient has achieved a BCVA of 0.7. Corneal sutures are still to be removed and further benefit is expected.


Post-refractive ectasia shows an increasing incidence and will probably come along with cataract or a non-emmetropic IOL. Cornea and lens must be evaluated altogether and optical system surgery is required as first line approach to restore visual acuity and quality. Any partial intervention will maintain the problem and difficult

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