Lens Subluxation And Femtolasik. Treatment Of Ametropia In An Exceptional Situation

To describe the clinical course and results of a patient with miopic astigmatism, wich presents with lens subluxation, in whom LASIK femtosecond laser treatment for ametropia was indicated

Department of Refractive Surgery. Institut Català de Retina. Barcelona

Patient requests surgery in order to apply for a career at security forces. Patient refers a high energy contusion in the periorbital región in early childhood in the left eye. We found myopia and astigmatism of similar magnitude and characteristics in both eyes. Under pharmacological mydriasis evidenced zonular dialisis in the left eye with subluxation of the crystalline lens.

After verifying the bilateral symmetry of the corneal topographic pattern, similar keratometry and pupillometry, no discrepancy in the different cylinder measurements (subjective, dilated aberrometry, etc.) and after carefully explaining and informing the patient about the possibility of complications, treatment with femtosecond laser was indicated

Uneventful LASIK surgery. Postop control at 24h, uncorrected visual acuity (UCVA) was: 20/20 and 20/25. Postoperative control 1 month after lasik, the UCVA = 20/20 and 20/20.

Control under pharmacological mydriasis, there are no changes in the characteristics of zonular dialysis. The patient remains asymptomatic and reports very good visual acuity.

To our knowledge, this is the first reported case of femtoLASIK for the treatment of myopia and astigmatism in an eye with asymptomatic lens subluxation. It is necessary to verify that the subluxation has no effect on the patient's graduation (astigmatism, ocular aberrations), otherwise the corneal photoablative treatment would not have the desired effect and could even compromise the visual quality of the affected eye.