First Author: V.Kanyukov RUSSIA
Co Author(s): D. Ilyukhin 0 0 0 0 0 0 0 0 0
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To represent the peculiarities of induced ametropia correction by the way of hypermetropic refraction after LASIK radial keratotomy (RKT).
The S. Fyodorov Eye Microsurgery Federal State Institution Orenburg Branch.
Patient L., 48 years old. RKT surgery was conducted on both eyes, 23 years ago. Visus presurgical: OD 0,5 Sph (+) 2,0 Cyl (-) 0,5 ax 100 = 1,0; OS 0,2 Sph (+) 3,5 Cyl (-) 2,5 ax 80 = 0,8. Pachymetry: OD 529 mn (centre), 581 mn (3,5 mm); OS 522 mn (centre), 628 mn (3,5 mm). Considering the cornea thickness, the biomicroscopic examination data, hypermetropic refraction and satisfactory data on TMS-4, LASIK surgery was carried out on the standard profile of ablation. The residual corneal thickness according to the calculated data after surgery at OD 436 mn (centre) and 455 mn in ablation maximum zone, and OS 429,4 and 474,9 mn respectively.
During the surgery on the right eye at the valve rise there was observed the divergence of two keratotomical cicatrices in the periphery, while on the left eye the divergence of all cicatrices for different depth and length was registered. Only stromal bed excepting cavities, formed in the thickness of the incisions, had been processed by the sponge. Thus, there was liquid, preventing excimer laser action on deeply lying sections. After laser ablation and adaptation of corneal graft there were placed contact lens on the eyeball with the bandage aim. On the second day after surgery and contact lens removal: OD 1,0; OS 0,9 Sph (-) 0,5 = 0,9-1,0. In addition to standard medical therapy the drugs enhancing the cornea regeneration were added in the treatment regimen. Control examination after 1 month showed the maximum uncorrected visual acuity of 1.0 in both eyes.
Excimer laser surgery can be an effective method of subcorrection of induced refractive disorders causing change in the shape of the cornea, can significantly improve uncorrected visual acuity. To avoid the described above intraoperative complications it requires careful examination of patients to determine the indications for correction of induced ametropia after RKT by LASIK, in particular conducting the confocal microscopy to determine the type and cicatrix substantiality, and visualization of cornea degenerative changes presence, despite the satisfactory data biomicroscopic examination.