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Year : 2020  |  Volume : 68  |  Issue : 11  |  Page : 2564-2567

Toric Artisan after transepithelial topography-guided photorefractive keratectomy for higher-order aberrations following intrastromal corneal ring segments in keratoconus – Trioptics

1 Department of Cornea, Sadalla Amin Ghanem Eye Hospital, Joinville, SC; Master (MSc) in Ophthalmology at the São Paulo State University, Botucatu, SP, Brazil
2 Department of Cornea, Sadalla Amin Ghanem Eye Hospital, Joinville, SC; Doctorate (PhD) at the São Paulo University (USP), Sao Paulo, SP, Brazil
3 Department of Cornea, Sadalla Amin Ghanem Eye Hospital, Joinville, SC, Brazil

Correspondence Address:
Dr. Gabriel de Almeida Ferreira
Sadalla Amin Ghanem Eye Hospital, 35, Camboriu Street. Joinville, SC
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijo.IJO_73_20

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We report a case of a 40-year-old female with keratoconus and high myopia who had previous ICRS implantation in both eyes (OU) and was intolerant to contact lenses. Manifest refraction was -8.50 -1.50 × 95 (20/25--) in right eye (OD) and -9.50 -2.50 × 60 (20/70--) in left eye (OS). A topography-guided transepithelial-photorefractive keratectomy (ttPRK) was performed to correct high-order aberrations on OS, resulting in corneal surface and coma improvement, and CDVA achieved 20/30. Correction of residual ametropia was performed with an iris-fixated toric phakic lens in OU. CDVA improved to 20/20- (Plano) in OD and 20/20- (Plano -1.00 90°) in OS. In conclusion, it is possible to rehabilitate a patient with keratoconus and high ametropia after intrastromal corneal ring segments (ICRS) implantation associating ttPRK and phakic lens (”Trioptics”).

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