Keratorefractive lenticule extraction after keratopigmentation case report

Introduction: Some patients who undergo elective keratopigmentation (KTP) are interested in subsequent refractive surgery. To the authors' knowledge, keratorefractive lenticule extraction (KLEx) after KTP has not been previously reported in the literature. Patient and Clinical Findings: A patient presented with myopia of −4.0 diopters (D) spherical and no significant astigmatism in both eyes, who had had KTP 6 months ago. KLEx was performed in both eyes following the usual protocol. Monovision (−1.25 D in the left nondominant eye) was planned. Diagnosis, Intervention, and Outcomes: Next day uncorrected distance visual acuity (UDVA) was 20/20-2 in the right eye and 20/30-1 in the left eye, with uncorrected near visual acuity (UNVA) with both eyes open of J3. After 1 month, her UDVA was 20/15-1 in the right eye and 20/20 (p/h 20/15-2) in the left eye, with UNVA with both eyes open of J2. The KLEx lenticule had small defects in the periphery, corresponding to the scar in vertical cuts of KTP. They did not affect topography of the optical zone or the visual outcome. Conclusions: The early results of KLEx after KTP seem promising, but more cases and further follow-up are necessary for reliable conclusions.