RESUMO
PURPOSE: To describe a patient with pellucid macular degeneration suffering from visual deterioration due to high irregular astigmatism and intolerant to contact lenses, who underwent a new surgical procedure that combined intrastromal lamellar keratoplasty and a 359° intracorneal ring segment implantation, enabling both ametropia and corneal thinning correction. METHODS: Case report. RESULTS: Refractive lenticule obtained during a myopic small incision lenticule extraction procedure was used as the donor lamellar graft. The technique described allowed for partial cylinder reduction and reinforcement of the thinned cornea. Uncorrected distance visual acuity improved from 0.02 to 0.5 (decimal) and corrected distance visual acuity improved from 0.4 to 0.7 with a decrease of 4.50 diopters in corneal astigmatism. CONCLUSIONS: Despite the lack of long-term observation, the new technique described in this case report was successful for this specific patient and therefore might be effective and safe in severe stages of disease. [J Refract Surg. 2019;35(9):606-609.].
