Lasik in 2000 and 2003. Emergency Corneal Transplant due to Intacs, now 20/25 with GVR Scleral Lens

These are photos of the right and left eye of a patient that underwent LASIK surgery in 2000 and once again in 2003 in each eye. Shortly after the 2nd LASIK procedure, this patient developed ectasia in her left eye. Her corneal surgeon attempted to insert Intacs (corneal rings) into her left cornea intending to smooth out the corneal surface. During the Intacs surgery the cornea got damaged forcing this patient to undergo an emergency corneal transplant. About 8 years later ectasia developed in this patient’s right eye. A different corneal surgeon in Central America suggested that Ferrara Rings be inserted in her right cornea. Ferrara rings are very similar to Intacs except that they do not have FDA approval in the United States. In addition, the separation of the Ferrara rings within the cornea is much closer than seen with Intacs and can interfere with night vision. Look carefully at the first photo. This shows the right cornea with the Ferrara rings. Note that these rings are along the pupillary border and are affecting this patient’s night vision. The 2nd photo shows this patient’s left cornea with the transplant. The white-gray ring circling the peripheral cornea is the junction between the host and donor cornea. Look carefully and you can see new blood vessel growth onto the donor cornea at 12:00 and 1:00. Rarely do these blood vessels traverse the host-donor interface. This condition will have to be monitored indefinitely This patient had not been able to tolerate any form of contact lens correction. In addition, eyeglasses did not provide her with functional vision. For the past 2 years this patient has been wearing scleral lenses which are allowing her to see clearly (20/25) in each eye with excellent comfort.

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