Management of Reverse Pellucid Type Topography

Area of Science:

• Ophthalmology
• Surgical Complications
• Refractive Surgery

Background:

• Rigid intraocular lens (IOL) implantation with wide limbal clear corneal incision (CCI) can lead to complications.
• Topographic reverse pellucid pattern is a potential outcome following such procedures.

Purpose of the Study:

• To evaluate the etiopathogenesis and management of topographic reverse pellucid pattern after rigid IOL implantation.
• To assess the outcomes of managing wound dehiscence following wide CCI.

Main Methods:

• Fifteen eyes with decreased vision post-IOL surgery and wide CCI (≥6.5 mm) were diagnosed with wound dehiscence.
• Management involved tight resuturation, delayed, and selective suture removal.
• Visual acuities and refractive errors were analyzed 6 months postoperatively.

Main Results:

• Uncorrected distance visual acuity (UDVA) improved in 86.7% of eyes, and corrected distance visual acuity (CDVA) improved by at least 2 Snellen lines in 73.3%.
• Astigmatism shifted from against-the-rule to with-the-rule, with decreasing cylinder as sutures were removed.
• Significant correction of astigmatism was observed, averaging 4.17 D (manifest) and 4.90 D (keratometric).

Conclusions:

• Low visual acuity and high astigmatism post-IOL surgery warrant consideration of wound dehiscence.
• Careful wound revision, including tight resuturation and selective suture removal, is an effective management strategy.
• Prompt surgical intervention can restore visual function and reduce astigmatism.