KERATOKONUSUN CƏRRAHİ YOLLARLA MÜALİCƏSİ (KLİNİKİ HAL)

Abstract

SUMMARY

We would like to present the surgical management of keratoconus. 34 years old Indian male patient had OSDALK (Big Bubble technique) surgery in left eye by Dr. Mohammad Anwar in Saudi Arabia in 1999. After some months patient had OS-Phaco+IOL surgery in left eye in “Swarup Eye Centre”, Hyderabad, India.
In 2012 the patient’s data were:
VisOD=0,02 not corrected; VisOS=0,16 -2,75/-8,0/120˚ 0,5
Refraction: OD -13,5/-5,25/70˚; OS -2,75/-7,75/110˚
TnOD=8 mmHg TnOS=15 mmHg
OD-Apical scar and thinning, Fleischer ring, conis shape (Photo1), clear lens, Posterior segment is normal; OS-After DALK surgery, clear graft, ectatic area in inferior graft-host junction (Photo2), pseudophakia, posterior segment is normal. In OptoVue OCT screening on right eye there are apical stromal scarring and thinning (Photo 3).
In 29.08.2012 the patient had OD-DALK (Groove and Peel technique) on right eye.
Postoperative 1st day: OD-clear graft, sutures are intact, graft-host junction is intact, the trace of microperforation area on Descemets membrane, clear lens.
Postoperative 1st month: VisOD=0,1 0,00/-5,5/60˚ 0,16; VisOS=0,16 -3,0/-8,0/120˚ 0,5
Refraction: OD +7,75/-9,5/60˚; OS -4,00/-9,0/120˚ TnOD=16 mmHg TnOS=17 mmHg.
Topographic guided sutures removal was performed step by step during 1 year (Photo 6, 7).
In OptoVue OCT screening on right eye there is some stromal tissue on descemet membrane (Photo 8). One year after sutures removal was there was steroid induced posterior subcapsular cataract in right eye (Photo9). Surgeon planned OD-Phaco+Toric IOL on right eye. Preoperative data: VisOD=0,1 0,00/-5,5/10˚ 0,3 Refraction: OD +1,25/-6,25/175˚ After Haigis intraocular lens calculation in September 2015 there performed OD-Phaco+Toric IOL surgery. Postoperative 1 month: VisOD = 0,5 0,00/-0,75/110˚= 0,7 VisOS = 0,16 -2,0/-9,0/120˚ = 0,5 Refraction: OD +0,5/+0,25/135˚ OS -4,00/-9,0/120˚ TnOD = 14 mmHg TnOS = 12 mmHg