A 30 years old male patient, presented with long history of diplopia, he underwent strabismus surgery at ages of 4, 23 years after which he had 3 trials of botox injections in 4 years, with no significant improvement of visual symptoms, he expressed worse double vision with the improvement of eye alignment, and visual acuity was 1.0 in each eye separately.
Several trial of refractive correction and prisms to improve the condition, none of them improved the symptoms, for that the patient had requested a more permanent solution, for which he was advised of the application of functional keratopigmentation to the right eye for the limitation of the visual symptoms.
Manual intrastromal keratopigmentation technique
using the VISSUM intrastromal micropigmentation system dissectors to fashion a 4 mm pupil and using brown pigment.
First visit postoperatively: patient expressed satisfaction with the relief of the visual disability symptoms with no pain or any other complications . Cosmetic evaluation showed a very good pupil profile.
Figure 2 : Top photo
Follow ups and Comments
On 6 months follow up: Patient was still satisfied with his results, and the cosmetic evaluation showed pigment slightly blurred at the edges due to peripheral pigment dispersion, with slight stromal corneal opacity, but with stable pupil diameter in high, medium and low mesopic conditions. Because of the patient´s satisfaction with the visual symptoms improvements’ , the surgeon chose not to perform further enhancement of the pupil profile.
Figure 3 : Top photo