A series of surgical interventions - relaxing corneal incisions, intraocular lens, and intrastromal rings - were used to correct a case of extreme ametropia in a thin cornea after a penetrating keratoplasty in an 18-year-old patient who presented with a -10.25 -8.50 × 120 preoperative refraction and 20/200 best-corrected visual acuity (BCVA). After a series of surgical procedures, the patient's BCVA in his left eye improved to 20/30 with +0.50 -1.00 × 170, the slit lamp examination showed no significant findings, and the patient's visual complaints disappeared. At the 1-year follow-up, the BCVA was 20/25, without visual complaints. The process of individualizing the surgical procedure in the present case was employed in an outcome-based approach, that is, the next surgical procedure was defined after the surgery and postoperative evaluation. The patient did not present complications during the follow-up period of 2.5 years.

Objetivo: Evaluar los resultados obtenidos con la técnica de queratomileusis in situ asistida con láser (LASIK, Laser Assisted in Situ Keratomileusis) con micromonovisión en pacientes présbitas hipermétropes. Método: Estudio retrospectivo, serie

Purpose:The purpose of the study was to evaluate the outcomes of micro-monovision laser-assisted in situ keratomileusis (LASIK) in hyperopic patients with presbyopia. Methods: Retrospective case series that identified hyperopic patients that underwent micro-monovision LASIK in the Visual Science Institute at hospital Zambrano Hellion from November 2018 to May 2019. A Technolas 217c (Bausch and Lomb) excimer laser was used. The target refraction for the dominant eye was Plano and for the non-dominant eye, between −0.75 and −1.50. Patients were followed-up for 6 months. Results: Sixty eyes of 30 consecutive patients were evaluated. Mean age was 51.63 years (± 4.55). Average refraction in the non-dominant eye was −1.34 ± 0.3. Eighty-seven percent of the patients achieved a 20/20 uncorrected binocular distance visual acuity and 100% achieved 20/40 or better. Ninety-seven percent achieved an uncorrected binocular near visual acuity of J2 or better and 100% of J4 or better. No eyes showed loss of lines with best spectacle-corrected visual acuity. We performed retreatment in one eye (2.9%). Conclusions: Micro-monovision LASIK is an effective, precise, and safe treatment option for presbyopia in hyperopic patients.

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