Saving Private Ryan (saving the patient’s cornea)
First Author: A.Titov RUSSIA
Co Author(s): D. Mirsaitova
To save and improve the sphericity of the cornea of a patient with stage 3 keratoconus in one eye and increase the refractive result in the paired eye after penetrating keratoplasty
The S. Fyodorov "Eye Microsurgery" Federal State Institution, St. Petersburg Branch
Patient, S., 37years old. Keratoconus of the right eye for about 8 years. History of operated keratoconus of the left eye, condition after penetrating keratoplasty Visus OD 0.03Sph-13.00Cyl-4.00ax 15=0.40, OS0.30Sph-2.50Cyl-3.25ax165=0.75. OD K1 56,2 D, K2 62,2 D axis89,5, OS K1 44,3 D, K2 49,6 D axis85,0.OD axial length23.69 mm, ACD4.05mm, lens thickness 4,08mm; OS axial length23.87 mm, ACD4.12 mm, lens thickness 4,18mm. IOP19 and 17mmHg. Сorneal thickness: OD–400mm, 559mm.Status localis–OD: Thinned, Fleischer ring, displacement of the apex of the cornea, OS: transparent cornea, postoperative corneal scar, condition after penetrating keratoplasty.Diagnosis: OD-keratoconus3, OS-operated keratoconus, the state after penetrating keratoplasty.
Results OD - Implantation of intrastromal corneal segments. (further planned CXL) OS - performing refractive surgery using the Smile technology. 1 day post-op: OD 0.40 Sph 0.00 Cyl 0.00 ax 0 = 0.40 OS 0.650 Sph 0.00 Cyl 0.00 ax 0 = 0.650 OD K1 52.0 D, K2 54.0 D axis 179.7 OS K1 43.2, K2 47.1 axis 87.4
This clinical example demonstrates the possibility of conducting organ-preserving technologies in the presence of stage 3 keratoconus and the possibility of performing refractive surgery using the Smile technology on the eye after penetrating keratoplasty.