Toric to monofocal intraocular lens exchange in patient with subepithelial fibroplasia after radial keratotomy. Clinical case

This clinical case demonstrates the toric to monofocal intraocular lens exchange due to the erroneous assessment of corneal topography in a patient with radial corneal scars after keratotomy. Toric intraocular lens power calculation was performed using initial parameters, when its central optical area was transparent, and at the mid-periphery, approximately 4–5 mm from the central optical area in the upper temporal quadrant, there was a subepithelial fibroplasia present. Postoperative refractive result was not optimal; residual astigmatism was noted, and it was decided to eliminate it by scarification of the epithelium in the area of fibroplasia. This lead to a significant change in keratometry and to practically total restoration of corneal spherical form. IOL exchange was performed, which caused an increase in visual function.