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Cataract surgery after radial keratotomy and your management of anisiometropia

Poster Details

First Author: L.Pucci BRAZIL

Co Author(s):    A. Binda   G. Junior   L. Duarte   M. Siqueira           

Abstract Details

Purpose:

Generate options on the management of anisiometropia after cataract surgery, in patients with corneal aberrations originating from radial keratotomy.

Setting:

CEMA HOSPITAL ,BRAZIL

Methods:

53 years old man, with history of radial keratotomy in both eyes. Referred for cataract surgery in right eye (OD) , after cataract surgery in other hospital. Visual acuity (VA) with best correction OD : Count Fingers 2 meters ; left eye (OS): 20/40(-2) (�,50 D Spherical ) . Biomicroscopy : OD : Inferior corneal opacity, nuclear cataract 4 . OS: pseudophakic , capsular bag Intra Ocular Lens (IOL) . Retinography demonstrates Staphyloma in both eyes. Pre operative discussion: IOL explantation OS ? Attempt to contact lens on OS ? Cataract surgery in OD first approach ?

Results:

Surgical approach on OD, and later, management on OS. Axial Length (AL) : 32.01mm (A-scan measurement) , IOL power calculated based on Haigis (fourth generation) formula with residual -1,50 D spherical equivalent refraction, monofocal three-Piece IOL (�,00D power lens) . Postoperative visual acuity OD : 20/30 (-1,50 D Spherical ) . OS management: 1st option : IOL explantation? 2�Â�° Rigid Contact Lens (RCL) fitting ? Reverse Curve RCL : both eyes: 34,00D /42,00D plano 11,4mm. Well fitting on corneal biomicroscopy . Visual acuity OD: 20/30 (-1,50 D Spherical ), OS : 20/20(-1) (�,50D Spherical ) .

Conclusions:

Anisiometropia after cataract surgery is a complication related to biometric errors. We outline some possible solutions when we are faced with this type of problem: 1st : IOL explant (greater action on anisiometropia) , 2nd : adaptation of RCL (acts on anisiometropia and corneal aberration) . For the patient in question , the second option was more adequate, which does not mean to be a rule and should be extended to all similar cases . The individualization of each case and patient satisfaction must always be in the foreground .

Financial Disclosure:

NONE

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