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

Abstract

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').