Dr.SHIVA PRASAD GANTYALA

Dr. ANANTH D., Dr. Nilesh Kumar

Abstract

Corneal ectasia in post-RK and LASIK with early cataract is a surgical challenge. A 45-year-old female presented with a diminution of vision RE for 20 years. The patient gave a surgical history of RK done 25 yrs back and top-up LASIK done 20yrs back. She has been using a contact lens for residual refractive error in both eyes. On examination BCVA in right eye (RE) was 6/60, in left eye (LE) was 6/9. RK scars were noted, with OD inferior corneal scarring from 6’o clock to 9’o clock, both eyes showed early cataract. Orbscan showed OD having a pachy of 354µm, inferio-superior asymmetry, inferior steepening of 64D suggesting iatrogenic keratoectasia. Biometry showed an axial length of 31.23mm, K1 of 57.75D@35° and K2 of 52D@125°. Modified Rosa formula was used to calculate the IOL power and an IOL of zero power was placed in the bag. On 3rd day and 1-month follow-up BCVA was 6/9 demonstrating a good visual outcome with modified Rosa formula without any prior surgical or keratometry details