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Titre	A complex case of late post-RK wound dehiscence treated with specialty lenses
Abstract Nr.	2045

But	To describe a case of spontaneous wound dehiscence 29 years post-radial keratotomy and its management with specialty contact lenses.
Méthodes	Case report
Résultats	A 62-years-old woman presented in November 2014 to the emergency unit with an acute dehiscence of 2 RK incisions in her left eye leading to corneal perforation and loss of the anterior chamber. Her past medical history was significant only for uncomplicated radial keratotomy surgery performed in 1985 to correct myopia (-5.50 D). OCT confirmed a wide tear of the inner face of the cornea over the full length of the 2 incisions and illustrated the importance of the intrastromal fluid accumulation, making suturing of the incisions not a very attractive option. Because of the bulging of the edematous inferotemporal cornea, it was not possible to fit a standard bandage lens. A silicone hydrogel lens with relatively flat base curve in a larger diameter was successfully adapted. After 4 months of uneventful bandage lens wear, the oedema had resolved substantially but BSCVA remained limited to 0.1. By fitting a scleral lens visual acuity was restored to 0.9+.
Conclusion	This case illustrates a more dramatic but very rare long term complication of RK. It is essential for corneal referral centres to dispose of all the necessary surgical techniques and non-surgical tools for managing highly complex corneas. The standard of care effectively should include specialty contact lenses for therapeutic use and visual rehabilitation. This exceptional case beautifully illustrates how specialty lenses can help save the integrity of the eye and restore sight in cases that have exhausted the refractive surgeon’s treatment options.

Auteur 1

Nom	BOVEN
Initiales	K
Institut	Antwerp University Hospital
Ville	Edegem

Auteur 2

Nom	Van den Heurck
Initiales	J

Auteur 3

Nom	Anthonissen
Initiales	L

Auteur 4

Nom	Van Hoey
Initiales	M

Auteur 5

Nom	Koppen
Initiales	C