Trans-scleral explantation of posteriorly dislocated IOL-CTR complex in a case of anterior megalophthalmos with an unusually thin cornea

The early development of lens opacities and lens subluxation are the most common causes of vision loss in patients with anterior megalophthalmos (AM). Cataract surgery in such patients is challenging, however, because of anatomical abnormalities. Intraocular lens dislocation is the most common postoperative complication. Patients with AM also seem to be affected by a type of vitreoretinopathy that predisposes them to retinal detachment. We here present the case of a 36-year-old man with bilateral AM misdiagnosed as simple megalocornea. He had a history of amaurosis in the right eye due to retinal detachment. He presented with vision loss in the left eye due to lens subluxation. Following the removal of the subluxated lens, it was deemed necessary to perform a vitrectomy in order to prevent retinal detachment. Seven months after surgery, an Artisan® Aphakia iris-claw lens was implanted in the anterior chamber. Fifteen months of follow-up data are provided.

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A novel case using femtosecond laser-acquired lenticule for recurrent pterygium: case report and literature review

Journal of International Medical Research ◽

10.1177/0300060518765303 ◽

2018 ◽

Vol 46 (6) ◽

pp. 2474-2480 ◽

Cited By ~ 3

Author(s):

Om Prakash Pant ◽

Ji-long Hao ◽

Dan-dan Zhou ◽

Fan Wang ◽

Cheng-wei Lu

Keyword(s):

Femtosecond Laser ◽

Corneal Thickness ◽

Anterior Segment ◽

Single Layer ◽

Cost Effective ◽

Laser Technique ◽

First Case ◽

Lenticule Extraction ◽

Recurrent Pterygium ◽

Thin Cornea

Small incision lenticule extraction (SMILE) is a minimally invasive, safe and flapless femtosecond laser technique used mainly to correct myopia through extraction of a corneal lenticule. Lenticules obtained in this way are transparent and of high quality, and thus, can be used to treat other corneal diseases. A 65-year-old male patient presented with recurrent pterygium complicated by thin cornea. The patient was treated surgically using a SMILE-extracted lenticule to avoid further complications and to maintain eyeball integrity. The lenticule was sutured over the thin section of cornea using 10-0 interrupted nylon sutures and enclosed by a single layer of amniotic membrane. The patient was evaluated using slit-lamp biomicroscopy and anterior-segment optical-coherence tomography. During an 8-month follow-up, the graft remained intact with no sign of rejection and corneal thickness was maintained. Tectonic keratoplasty using a SMILE-extracted lenticule appears to be a safe, cost-effective and reliable method for treating thin cornea due to repeated surgeries for recurrent pterygium. This is the first case of recurrent pterygium complicated by thin cornea managed surgically using a SMILE-extracted lenticule.

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