Abordaje de un paciente con queratocono, extrusión de anillos intraestromales y adaptación de lentes de contacto: reporte de caso

Abstract

Keratoconus is a condition that produces asymmetric irregular astigmatism and usually appears in the second decade of life affecting the patient's development due to the visual distortion it causes (1). Objective: To report the case of a patient diagnosed with keratoconus, crosslinking and extraction of intrastromal rings, to identify and understand the clinical and functional behavior of the adaptation of specially designed contact lenses as an alternative to keratoplasty. Methodology: Descriptive observational study type case report. A description is made of a 43 year-old female patient with a history of keratoconus, crosslinking, implantation of intrastromal rings and subsequent extrusion of these causing corneal irregularity. The results obtained are shown where two types of contact lenses were evaluated: rigid corneal and scleral support. The first one showed a better fluorographic pattern and comfort, a good tolerance on the scleral that, despite being a comfortable lens, presented an excessive clearance in the paracentral area corresponding to the ring extraction area, pinching and compression zones; it was decided to test a readaptation of a rigid gas permeable lens to assess tolerance and vision to promote corneal oxygenation. Conclusions: This report shows how it is possible to use a simpler design prioritizing corneal integrity, and avoiding hypoxia to ensure good tolerance; therefore, in this case, it is considered that the rigid corneal lens is a good option since if the corneal irregularity is marked, it makes the adaptation of the scleral difficult