Indian Journal of Ophthalmology (Jan 2012)
Deep anterior lamellar keratoplasty for the management of iatrogenic keratectasia occurring after hexagonal keratotomy
- Paras Mehta,
- Varsha M Rathi,
- Somasheila I Murthy
Affiliations
- Paras Mehta
- Varsha M Rathi
- Somasheila I Murthy
- DOI
- https://doi.org/10.4103/0301-4738.94058
- Journal volume & issue
-
Vol. 60,
no. 2
pp. 139 – 141
Abstract
Iatrogenic keratectasia has been reported subsequent to refractive surgery or trauma. Hexagonal keratotomy (HK) is a surgical incisional technique to correct hyperopia. A number of complications have been reported following this procedure, including irregular astigmatism, wound healing abnormalities and corneal ectasia. When visual acuity is poor because of ectasia or irregular astigmatism and contact lens fitting is not possible, penetrating or lamellar keratoplasty can be performed. Since incisions in refractive keratotomy are set at 90-95% depth of cornea, intraoperative microperforations are known to occur and lamellar keratoplasty may become difficult. We describe deep anterior lamellar keratoplasty (DALK) used to successfully manage keratectasia after HK. Pre DALK vision was 20/400 and post DALK vision was 20/30 two months after surgery. This report aims to show improved visual outcome in corneal ectasia secondary to HK. DALK can be a procedure of choice with proper case selection.
Keywords
- Orbit
- proptosis
- thyroid
- Hyperhomocysteinemia
- retinal arterial occlusions
- systemic associations
- young age
- Illumination
- letter charts
- visual acuity
- Dacryocystorhinostomy
- intraocular pressure
- systemic effects
- timolol maleate
- Accommodation
- dynamic retinoscopy
- ophthalmoscopy
- photorefraction
- photoretinoscopy
- Apoptosis
- corneal epithelium
- formulation
- sphingosine-1 phosphate
- Digital camera
- external photograph
- photography
- Android
- eye handbook
- iPhone
- smart phone
- testing tools
- Anterior chamber intraocular lens
- gyrate atrophy
- posterior dislocation of intraocular lens
- psuedophakia
- Conjunctival ulcer
- conjunctivitis
- Stenotrophomonas maltophilia
- Adrenergic blocker
- imipramine
- intraoperative floppy iris syndrome
- iris hooks
- phacoemulsification
- Corneal ectasia
- deep anterior lamellar keratoplasty
- hexagonal keratotomy
- hyperopia