reporte de caso: adaptación de lente rígido de apoyo escleral en un páciente con cornea irregular post queratotomia radial y lasik complementario en un centro de referencia en Bogota (2014)

Abstract

Radial keratotomy (RK) was a widely used procedure for myopia correction during the 1980s and 1990s; however, long-term complications such as corneal irregularity, irregular astigmatism, and decreased visual quality were later reported. Some patients subsequently underwent additional procedures such as LASIK (Laser-Assisted In Situ Keratomileusis), with variable outcomes. Objective: To describe the fitting process of a scleral support lens in a patient with irregular cornea secondary to radial keratotomy and complementary LASIK. Methodology: A descriptive observational case report in which an Airkone Scleral Toric lens was fitted in both eyes, assessing fit parameters, comfort, and visual performance. Case presentation: A 60-year-old male patient with a history of RK, LASIK, and cataract surgery with toric intraocular lens implantation consulted due to persistent decreased vision and functional limitation. Results: The initial adaptation with rigid gas permeable lenses provided partial improvement in visual acuity, achieving 20/25 distance vision in both eyes and near vision with +3.00 Diopters addition at 0.50 m, although with poor tolerance and mild epithelial signs. In contrast, the Airkone Scleral Toric lenses proved stable, comfortable, and safe, providing 20/25 distance visual acuity in both eyes and adequate near vision with reading glasses (+3.00 Diopters addition), while also improving ocular surface protection and refractive stability. Conclusions: Scleral support lenses represent an effective and safe alternative for visual rehabilitation in post-surgical irregular corneas, offering enhanced optical quality, comfort, and corneal structural preservation during prolonged wear.