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BRIEF COMMUNICATION
Year : 2012  |  Volume : 60  |  Issue : 2  |  Page : 139-141

Deep anterior lamellar keratoplasty for the management of iatrogenic keratectasia occurring after hexagonal keratotomy


1 Cornea, External Disease and Refractive Surgery, Sameep Eye Hospital and Corneal Centre, Baroda, Gujarat, India
2 Cornea and Anterior Segment Services, LV Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, India

Correspondence Address:
Somasheila I Murthy
LV Prasad Eye Institute, LV Prasad Marg, Banjara Hills, Hyderabad - 500 034
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0301-4738.94058

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Iatrogenic keratectasia has been reported subsequent to refractive surgery or trauma. Hexagonal keratotomy (HK) is a surgical incisional technique to correct hyperopia. A number of complications have been reported following this procedure, including irregular astigmatism, wound healing abnormalities and corneal ectasia. When visual acuity is poor because of ectasia or irregular astigmatism and contact lens fitting is not possible, penetrating or lamellar keratoplasty can be performed. Since incisions in refractive keratotomy are set at 90-95% depth of cornea, intraoperative microperforations are known to occur and lamellar keratoplasty may become difficult. We describe deep anterior lamellar keratoplasty (DALK) used to successfully manage keratectasia after HK. Pre DALK vision was 20/400 and post DALK vision was 20/30 two months after surgery. This report aims to show improved visual outcome in corneal ectasia secondary to HK. DALK can be a procedure of choice with proper case selection.


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