Chhadva Priyanka, Cabot Florence, Galor Anat, Yoo Sonia H
University of Miami Miller School of Medicine, Bascom Palmer Eye Institute, Miami, FL 33136, USA.
University of Miami Miller School of Medicine, Bascom Palmer Eye Institute, Miami, FL 33136, USA ; Ophthalmic Biophysics Center, McKnight Vision Center, Miami, FL 33136, USA.
Case Rep Ophthalmol Med. 2015;2015:592495. doi: 10.1155/2015/592495. Epub 2015 Mar 19.
Purpose. To describe a case of 3 refractive procedures performed in one eye over 2 decades. Methods.
Results. A 41-year-old patient presented for refractive surgery evaluation. His ocular history includes bilateral radial keratotomy performed 21 years ago for moderate myopia: spherical equivalence of -4.25 D bilaterally. Postoperative uncorrected visual acuity (UCVA) was 20/30; however, over time he developed a hyperopic shift and UCVA decreased to 20/40 in the right eye. Thus, laser-assisted in situ keratomileusis (LASIK) was performed at an outside institution 6.5 years later, and the patient had initial improvement of UCVA to 20/25. Due to a change in refractive error, the patient underwent uneventful astigmatic keratotomy 13 years after LASIK in the right eye, and 1.5 years after surgery best-corrected visual acuity was 20/25 with manifest refraction of -1.00 + 5.50 × 134°. Conclusion. We report the outcomes and natural refractive progression in a patient who underwent three corneal refractive procedures over two decades. This case underlines the difficulties of long-term management of post-RK hyperopia and astigmatism.
目的。描述一例在20年内在一只眼睛上进行3种屈光手术的病例。方法。
结果。一名41岁患者前来接受屈光手术评估。他的眼部病史包括21年前因中度近视进行的双侧放射状角膜切开术：双侧等效球镜度数为-4.25D。术后裸眼视力（UCVA）为20/30；然而，随着时间的推移，他出现了远视漂移，右眼UCVA降至20/40。因此，6.5年后在外部机构进行了准分子原位角膜磨镶术（LASIK），患者的UCVA最初提高到20/25。由于屈光不正的变化，患者在右眼LASIK术后13年接受了顺利的散光角膜切开术，术后1.5年最佳矫正视力为20/25，明显屈光不正为-1.00 + 5.50 × 134°。结论。我们报告了一名患者在20年内接受三种角膜屈光手术的结果和自然屈光进展。该病例强调了RK术后远视和散光长期管理的困难。
