Case 3: Corneal Injury Sustained From An Eye Drop Bottle After Cataract Surgery - OCULUS Pentacam Interpretation Manual

6 The Fast Screening Report
6.3 Case 3: Corneal injury sustained from an eye drop bottle after
cataract surgery
A 54-year-old patient underwent cataract surgery on his highly myopic right eye. The surgery was
performed without any complications, resulting in a postoperative visual acuity of 20/20 with
refraction values of sph -1.75 cyl -0.75 A 25°. After 3 weeks the patient complained of deteriorated
visual acuity without pain.
Slit lamp microscopy showed the cornea to be completely transparent, with a small irregularity
paracentrally. His refraction had changed to sph -4.50 cyl -1.50 A 108° and his visual acuity had
dropped to 20/25, and there was no intraocular irritation. The possibility of a macular oedema
(Irvine-Glass syndrome) was reliably excluded by fundoscopy. The patient expressed dissatisfaction
at this unexpected turn of events, but on inquiry remembered having knocked the eye drop bottle
against his right eye.
Analysis based on the Pentacam® Fast Screening Report revealed an abnormal value for K Max
(anterior surface) as well as anterior and posterior elevation
4 Maps Refractive color display via the navigation bar it was possible explain the changes to
the patient. He was able to see for himself the abnormal distribution of refractive power and
anterior elevation profile around the centre of his right pupil
measurements showed that the disturbance had subsided, with refraction values of sph -2.00 cyl
-0.25 A 0° and visual acuity back at 20/20. The patient was shown the Compare 2 Exams display,
demonstrating the improvement that had occurred in only a week
postpone refitting his spectacle lenses by 2 weeks, since the Pentacam® analysis indicated that his
right-eye refraction had not yet reached its ultimate distribution.
Figure 23: Fast Screening Report showing suspicious values of K Max (anterior surface)
and anterior and posterior elevation
26
(Figure 23). After calling up the
(Figure 24). A week later Pentacam®
(Figure 25). It was decided to