title: Management of extreme ametropia after penetrating keratoplasty: a series of surgical procedures for high myopia and astigmatism.
abstract: A series of surgical interventions - relaxing corneal incisions, intraocular lens, and intrastromal rings - were used to correct a case of extreme ametropia in a thin cornea after a penetrating keratoplasty in an 18-year-old patient who presented with a -10.25 -8.50 × 120 preoperative refraction and 20/200 best-corrected visual acuity (BCVA). After a series of surgical procedures, the patient's BCVA in his left eye improved to 20/30 with +0.50 -1.00 × 170, the slit lamp examination showed no significant findings, and the patient's visual complaints disappeared. At the 1-year follow-up, the BCVA was 20/25, without visual complaints. The process of individualizing the surgical procedure in the present case was employed in an outcome-based approach, that is, the next surgical procedure was defined after the surgery and postoperative evaluation. The patient did not present complications during the follow-up period of 2.5 years.
authors.affiliation: Ophthalmology Research Chair, School of Medicine and Health Sciences, Monterrey, Mexico ; Instituto de Oftalmología y Ciencias Visuales - TECSalud, Tecnológico de Monterrey, Monterrey, Mexico.
authors.forename: Jorge E
authors.initials: JE
authors.lastname: Valdez-Garcia
authors.affiliation: Ophthalmology Research Chair, School of Medicine and Health Sciences, Monterrey, Mexico.
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Cueto-Gómez
authors.affiliation: Ophthalmology Research Chair, School of Medicine and Health Sciences, Monterrey, Mexico.
authors.forename: Juan F
authors.initials: JF
authors.lastname: Lozano-Ramírez
authors.affiliation: Ophthalmology Research Chair, School of Medicine and Health Sciences, Monterrey, Mexico.
authors.forename: Alejandro E
authors.initials: AE
authors.lastname: Tamez-Peña
keywords: Ametropia; Astigmatism; Keratoplasty; Myopia; Refractive surgery