Addition by Subtraction: Reversing Epikeratophakia and Stromal Scarring in a Patient With Myopia Magna.

IF 2.1 3区医学 Q2 OPHTHALMOLOGY Cornea Pub Date : 2025-01-24 DOI:10.1097/ICO.0000000000003797

Jascha A Wendelstein, Katrin Freller, Kamran M Riaz, Theo G Seiler

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Abstract

Purpose: To describe a three-phase surgical approach for managing progressive visual decline in a patient with myopia magna and a history of epikeratophakia.

Methods: A 55-year-old woman with previous epikeratophakia surgery in both eyes experienced progressive visual deterioration. The three-phase approach included: (1) removal of the epikeratophakia lenticule, (2) cataract extraction with intraocular lens implantation, and (3) transepithelial topography-guided photorefractive keratectomy (trans-PRK). Preoperative and postoperative refraction, corneal topography, and visual acuity were assessed.

Results: After trans-PRK, the right eye exhibited regularization of the corneal surface, with a final best spectacle-corrected acuity of 0.15 logMAR. A similar two-phase approach without lenticule removal was applied to the left eye, resulting in improved visual outcomes.

Conclusions: A three-phase surgical approach combining lenticule removal, cataract surgery, and topography-guided PRK offers a potential pathway for visual improvement in patients with phakic postepikeratophakia.

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加减法：逆转大近视患者的外角膜脱落和间质瘢痕。

目的：描述一个三阶段的手术方法来管理进行性视力下降的患者与大近视和角膜外斜视的历史。方法：一名55岁女性，既往双眼角膜外晶状体手术，视力逐渐恶化。三阶段方法包括：(1)角膜表面晶状体摘除，(2)白内障摘出合并人工晶状体植入术，(3)经上皮地形图引导的光屈光性角膜切除术（trans-PRK）。评估术前和术后屈光、角膜地形图和视力。结果：经trans-PRK后，右眼角膜表面呈现规则化，最终最佳眼镜矫正视力为0.15 logMAR。在左眼采用了类似的两阶段手术，但没有去除晶状体，结果改善了视力。结论：晶状体切除、白内障手术和地形引导PRK相结合的三阶段手术方法为晶状体后角膜晶状体患者的视力改善提供了一条潜在途径。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cornea 医学-眼科学

CiteScore

5.20

自引率

10.70%

发文量

354

审稿时长

3-6 weeks

期刊介绍： For corneal specialists and for all general ophthalmologists with an interest in this exciting subspecialty, Cornea brings together the latest clinical and basic research on the cornea and the anterior segment of the eye. Each volume is peer-reviewed by Cornea''s board of world-renowned experts and fully indexed in archival format. Your subscription brings you the latest developments in your field and a growing library of valuable professional references. Sponsored by The Cornea Society which was founded as the Castroviejo Cornea Society in 1975.