Ceratectomia fotorrefrativa baseada em topografia para correção da hipermetropia secundária à ceratotomia radial

Abstract

Considering that it is a retreatment procedure performed in unstable and irregular corneas with high degrees of hyperopia, topographically guided photorefractive keratectomy showed good results and was safe and effective for the management of secondary hyperopia following radial keratectomy.

LIO pseudofácica suplementar sulcoflex® toric sobre LIO acrysof® toric

“…In many eyes submitted to RK the procedure is associated with the astigmatic technique using transverse incisions, further accentuating corneal instability and irregular astigmatism (2) due to the coupling effect in which the cornea is flattened in the incision's meridian with compensatory bulging in the perpendicular meridian (5) . Corneal suture has been used as an alternative to correct undesirable flattening, either by simple interrupted sutures, simple circular suture, double circular suture, or a combination thereof, aiming to flatten the peripheral cornea and thus curve its central region.…”

“…The Sulcoflex™ IOL is mainly indicated for correction of spherical or cylindrical pseudophakic ametropias or pseudophakic presbyopia, but it has been suggested preoperatively to surgical correction of high refractive errors, congenital cataract, and corneal astigmatism, among others (2) . Calculation of the refractive power of the IOL is done through the website www.toriciol.rayner.com, and the IOL has a single adding power of +3.50 D for presbyopia.…”

“…They usually consist of anisometropias leading to low quality of vision and patient dissatisfaction. Several therapeutic options are suggested, such as circular suture, suture of incisions, photorefractive keratectomy (PRK), laser-assisted in situ keratomileusis (LASIK), and phacorefractive surgery (2) . Phacoemulsification has been gaining support among ophthalmologists, especially after the introduction of advances that provide better biometric calculation and intraocular lenses (IOLs) with special designs.…”

“…The haptics have a posterior angulation of 10 degrees, increasing separation with the iris anteriorly and the primary IOL posteriorly and reducing the risk of interlenticular opacification (a frequent complication of piggyback plano-convex IOLs, especially if both IOLs are in the capsular bag) (4) . Even though it is primarily indicated for correction of spherical or cylindrical pseudophakic ametropias, or even pseudophakic presbyopia, it has been suggested preoperatively for surgical correction of high refractive errors, congenital cataract and corneal astigmatism, among others (2) .…”

Ceratectomia fotorrefrativa (PRK) com mitomicina C a 0,02% para correção de grau acentuado de astigmatismo hipermetrópico composto secundário a cirurgia de ceratotomia radial (RK)

“…Seu mecanismo de ação mimetiza a radiação ionizante com uma ação que se prolonga após a interrupção do tratamento (7) . É utilizada em muitas áreas da oftalmologia como em cirurgias de glaucoma, pterígio, neoplasias de conjuntiva e córnea, penfigóide ocular cicatricial, atenuação dos períodos de exacerbação da ceratoconjuntivite primaveril e recentemente em cirurgias refrativas (6)(7)(8)(9)(10) Como efeitos colaterais foram citados na literatura: fotossensibilidade, dor ocular, edema de córnea, glaucoma secundário, hiperemia conjuntival e palpebral, oclusão do ponto lacrimal inferior (7).…”