Cataract Surgery in Patient With Superiorly Located Keratoconus

Friday, April 25, 2014
KIOSKS (Boston Convention and Exhibition Center)
Onur Gokmen, MD Ankara, Turkey
Dilek D. Altinors, MD Ankara, Turkey

Narrative Responses:

Purpose
To describe a case with a superiorly located  keratoconus who developed corneal asymmetry in the upper quadrant  and was  treated with corneal wedge resection.

Methods
A 75 years old man presented to our clinic with low vision in his both eyes. His corrected visiul acuity was hand motion in the right eye and 5/100 in the left eye.  Ocular examination showed presence of  papillary reaction and severe allergic conjonctivitis in both eyes and superior cone formation on the right cornea due to rubbing.  He had nuclear sclerosis in the right eye. However, refraction,  keratometry and biometry coudn’t be  measured in that eye.  Flat and steep K values by Wavelight oculyzer 2 on the right eye were 14.33mm and 5.62mm.

Results
We planned crescent like wedge resection and primary corneal suturation in the superior quadrant of the cornea.  6 weeks after surgery,  best corrected visual acuity was 20/100 in the right eye.  Flat and steep K values were better  and a biometric measurement could be obtained.

Conclusion
Wedge resection and primary suturation is an alternative approach to superiorly  located keratoconus resembling pellucid marginal degeneration.