RESUMO
Two male patients, aged 64 and 55 years old, presented at the cornea department for a Boston type 1 keratoprosthesis (Kpro I) implantation after multiple corneal graft failures. After surgery, they achieved a best corrected visual acuity of 20/200 and 20/150, respectively. However, they manifested photophobia and aesthetic complaints. Both patients underwent keratopigmentation to improve the aesthetic outcome using vegetable pigments, after mechanical corneal deepithelization, with no intraoperative or postoperative incidents or adverse events. After 1-year follow-up, the patients presented the same best corrected visual acuity with improvement of the aesthetic outcome.
Assuntos
Órgãos Artificiais , Córnea , Doenças da Córnea/cirurgia , Estética , Fotofobia/terapia , Próteses e Implantes , Tatuagem/métodos , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: The following report presents the adaptation of an existing technique of intrastromal corneal ring (ICRS) implantation enabling repositioning of the ring position postoperatively to manage a refractive failure in two patients with keratoconus. METHODS: In two cases, KeraRing and Ferrara nomograms had suggested different ring positions. To manage with the differences between the two nomograms, a longer corneal tunnel was created followed by the classic intervention to move the ring through the initial intrastromal corneal tunnel according to the topographic values. Once the first ring position has failed, the ring segment was repositioned along the longer corneal tunnel according to the postoperative outcome. RESULTS: Significant improvement in both cases was observed in the best corrected visual acuity (BCVA), uncorrected visual acuity (UCVA), and root mean square (RMS) measured with Scheimpflug imaging (Pentacam; Oculus GmBH, Wetzlar, Germany). The participants were followed for one year. CONCLUSION: In patients with keratoconus which exhibit significant differences between KeraRing and Ferrara nomograms, a longer tunnel should be created to enable repositioning of the ring postoperatively if necessary, to avoid extracting the ring or changing it.