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A -20.00D piggyback in a malignant myopia patient with keratoconus

Poster Details

First Author: J.Ponce Martinez MEXICO

Co Author(s):    J. Ponce Martinez                    

Abstract Details


We present a 49 year old female with the diagnosis of keratoconus asks for a refractive surgical solution due to contact lens intolerance. Rx OD: -25.50, -1.00 x 165º 20/800, OS: -21.00, -1.00 x45º 20/200. K: OD 65.1/62.7 x 174º. OI 53.6/51.0 x 6º.


VA OD counting fingers15 cm, OS counting fingers 30 cm. Anterior Segment OD: apical 3mm subepithelial central leucoma. OS central Vogt striae and paracentral leucoma. Posterior pole ODS: choroidal fundus, optic disc with peripherial atrophy and macular excavation 50%.


So a phacoemulsiphication is propossed and the following IOL calculation is presented: IOL Master: AL: OD 33.45mm, plano IOL power -44.00D using SRK-T and OS 28.19mm. OD -44.00D , plano -9.5 D using SRK-T. We decided to implant two hydrophilic acrylic foldable IOLs (I-Flex) i with -10.00 D power


The surgery went without complications, the two IOLs were inyected in the bag. Two months follow up: OD Rx -3.50 sph BCVA 20/80.


Despite the high AL and non conclusive IOL power we decided to implant the two -10.00D IOLs which were the more negative power available in our country. And because of the uncommon big capsule bag; the IOLs were implanted in it,leaving the sulcus free. The patient had a good visual outcome and achieved contact lens independency.

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