Case Report: Acute Hydrops with Descemet Membrane Schisis in Corneal Ectasia after Radial Keratotomy

A 51-year-old man presented with a history of cloudy vision in the left eye with minimal discomfort. On slitlamp examination, he had 4 well-healed radial keratotomy (RK) incisions in each eye. Severe corneal edema was observed in the inferotemporal aspect of the left eye, consistent with acute hydrops. The patient was managed conservatively with observation and frequent topical lubrication for comfort. The clinical signs of corneal edema resolved over a period of several months, with worsened resultant scarring around the 5-o'clock keratotomy incision. Corneal ectasia is an established late complication of RK. Of interest in this case, the area of corneal hydrops was well demarcated because the RK scars formed a barrier against further progression of corneal edema.

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Acute corneal hydrops with iatrogenic keratoconus 20 years after radial keratotomy

Gill

Shew

McGhee

et al. 2021

JCRS Online Case Rep

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Restoration of Ocular Surface and Correction of Irregular Corneas Caused by Radial Keratotomy Using EyePrintPRO<sup>TM</sup> Technology (Case Report)

Forbes¹,

Boschniсk

2022

jour

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Background. The number of laser refractive surgeries to treat myopia is growing, and so does the number of complications. One of these complications, leading to progressive loss of vision, is iatrogenic corneal ectasia, which is difficult to correct and often causes work incapacity.Purpose. The purpose of this case report is to demonstrate the possibilities of correcting iatrogenic corneal ectasia with contact lenses utilizing EyePrintPROTM technology.Materials and methods. A clinical case describes the correction of iatrogenic progressive hyperopia with EyePrintPROTM contact lenses in a 52-year-old white male. The patient underwent several refractive surgeries, including Radial Keratotomy, Lasik and Cross-Linking, which resulted in peripheral corneal ectasia and progressive hyperopia. Previously fitted scleral lenses did not provide comfort and caused hyperemia and a foreign body sensation. The patient underwent a complete ophthalmological examination, including special examinations required for calculation of contact lens parameters. The EyePrintPROTM lenses were made by taking an impression of the anterior ocular surface. In addition, an analysis of literature on corneal ectasia available on PubMed, eLibrary, Cyberleninka, Crossref metadata search and other resources was carried out.Results and discussion. Thanks to EyePrintPROTM technology, it was possible to restore visual acuity and comfort: visual acuity increased from 0.16 to 1.0 in OD and from 0.4 to 1.0 in OS. Despite the presence of a pinguecula in the left eye, an adequate fit was achieved as demonstrated by optical coherence tomography (OCT) of the anterior segment of the eye. The discussion section provides a literature-based analysis of the causes leading to the occurrence of iatrogenic ectasia and expands on specifics of treatment of this pathology.Conclusion. Impressionbased contact lenses may be a preferred choice for patients with corneal and scleral irregularities.

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Case Report: Acute Hydrops with Descemet Membrane Schisis in Corneal Ectasia after Radial Keratotomy

Cited by 2 publications

References 24 publications

Acute corneal hydrops with iatrogenic keratoconus 20 years after radial keratotomy

Acute corneal hydrops with iatrogenic keratoconus 20 years after radial keratotomy

Restoration of Ocular Surface and Correction of Irregular Corneas Caused by Radial Keratotomy Using EyePrintPRO<sup>TM</sup> Technology (Case Report)

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