title: Combined corneal collagen crosslinking and secondary intraocular lens implantation for keratectasia after radial keratotomy.
abstract: We describe a case of corneal ectasia in a patient with previous radial keratotomy (RK). The uncorrected distance visual acuity (UDVA) was 20/400, the corrected visual acuity (CDVA) 20/50, and the spherical equivalent (SE) -5.125 diopters (D). Corneal topography revealed inferior corneal ectasia with corneal astigmatism of 9.2 D. Six months after corneal collagen crosslinking (CXL), the UDVA improved to 20/200, the CDVA to 20/40, and the SE to -4.625 D. Corneal astigmatism was reduced to 8.7 D. An add-on IOL was implanted to correct the residual cylindrical refractive error (-9.25 × 60; Torica-sPB IOL, Humanoptics), after which the UDVA improved to 20/32, the CDVA to 20/30, and the SE to -0.50 D. This case is the first to document the efficacy of CXL in corneal ectasia as a complication of primary RK in a nonkeratoconic or a keratoconus-suspect eye with an add-on IOL used to correct the residual refractive error.
authors.affiliation: From the Hospital Egas Moniz (Ferreira), the Hospital da Cruz Vermelha Portuguesa (Ferreira, Marques), and the Instituto de Oftalmologia Dr. Gama Pinto (Filipe), Lisbon, Portugal. Electronic address: tiagoferreira@netcabo.pt.
authors.forename: Tiago B
authors.initials: TB
authors.lastname: Ferreira
authors.affiliation: From the Hospital Egas Moniz (Ferreira), the Hospital da Cruz Vermelha Portuguesa (Ferreira, Marques), and the Instituto de Oftalmologia Dr. Gama Pinto (Filipe), Lisbon, Portugal.
authors.forename: Eduardo F
authors.initials: EF
authors.lastname: Marques
authors.affiliation: From the Hospital Egas Moniz (Ferreira), the Hospital da Cruz Vermelha Portuguesa (Ferreira, Marques), and the Instituto de Oftalmologia Dr. Gama Pinto (Filipe), Lisbon, Portugal.
authors.forename: Helena P
authors.initials: HP
authors.lastname: Filipe
mesh_terms: D003094:Collagen / Q000378:metabolism*; D003131:Combined Modality Therapy; D003319:Corneal Stroma / Q000378:metabolism*; D019781:Corneal Topography; D003432:Cross-Linking Reagents / Q000627:therapeutic use*; D004108:Dilatation, Pathologic / Q000209:etiology / Q000628:therapy; D006801:Humans; D007640:Keratoconus / Q000209:etiology / Q000628:therapy*; D007646:Keratotomy, Radial / Q000009:adverse effects*; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D014792:Visual Acuity / Q000502:physiology
chemical_list: D003432:Cross-Linking Reagents; D003094:Collagen