Refractive Lenticule Extraction In Primary Megalocornea

To prove that small incision lenticule extraction is a viable treatment option for myopia and astigmatism in primary megalocornea where the cornea is thinned and streched out with a very flat K.Literature review shows that there has not been a single published case for the same .LASIK /PRK have never been attempted in Primary Megalocornea as a treatment option.This in our opinion is the first recorded case in the world.

Dr Cyres mehta,s International eye centre a tertiary care eye clinic in Mumbai,India

Informed consent was obtained .Examination and surgery were carried out by the primary author.Detailed slit lamp examination was performed to confirm primary megalocornea .Refraction topography and OCT pachymetry were performed .Then OCT of the macula and dilated Indirect ophthalmoscopy were done.IOP was checked .Gonioscopy was carried out to rule out angle dysgenesis.After cleaning the eye with betadine and numbing them with proparacaine eyedrops 0.5% ,a speculum was insterted ,the eyes were docked on to  the Visumax500  laser which created the lenticule. Then the stromal lenticule was extracted manually .Refraction topography and pachymetry were carried out for the study at 3 months.

The patient was rendered emmetropic after the procedure.UCVA  was 20/20 with only a residual refraction of  -0.25D bilaterally . Post op topography and pachymetry showed a stable cornea after 3 months with no attendant dryness or visual phenomena.The patient resumed swimming and other sports in a week following the procedure.

Small incision lenticular extraction is a viable treatment option for primary megalocornea .