Intrastromal Lenticule Rotation for the Treatment of High Astigmatism

PURPOSE: To describe the first clinical case using intrastromal lenticule rotation to surgically correct high astigmatism in an amblyopic eye. METHODS: A 31-year-old woman with mixed astigmatism of +2.00 −5.00 × 10° (spherical equivalent −0.50 diopters [D]) in her left eye, uncorrected distance visual acuity (UDVA) of 0.8 logMAR, and corrected distance visual acuity (CDVA) of 0.7 logMAR underwent refractive lenticule rotation surgery. RESULTS: Postoperative refractive astigmatism changed to 0.00 D cylinder. There was a postoperative myopic shift and her spherical equivalent refraction was −4.00 D at 1 week, −3.75 D at 1 month, and −3.25 D at 3 and 6 months. The patient noted a slight improvement in UDVA and a significant improvement in her uncorrected near visual acuity from Jaeger 13 (> 1.0 logMAR) to Jaeger 5 (0.3 logMAR) at 1 and 3 months and subsequently to Jaeger 2 (0.1 logMAR). CONCLUSIONS: To the best of the authors' knowledge, this is the first clinical case of astigmatism correction using small incision lenticule extraction lenticule rotation. This case of an amblyopic eye demonstrates that the procedure is capable of correcting both corneal and refractive astigmatism, and the short-term result seems stable. [ J Refract Surg . 2020;36(6):415–418.]