Novel pinhole intraocular implant for the treatment of irregular corneal astigmatism and severe light sensitivity after penetrating keratoplasty

We present a case of decreased visual acuity due to irregular corneal astigmatism associated with intractable light sensitivity because of a fixed dilated pupil (Urrets-Zavalia syndrome) after penetrating keratoplasty. Because the corneal astigmatism was highly irregular, the corrected distance visual acuity (CDVA) was limited to 20/200 and the patient was dependent on a rigid contact lens, with very poor tolerance. The problem was addressed with a novel small-aperture supplementary intraocular implant, which reduces light entrance and minimizes the impact of corneal aberration on the optical system based on the pinhole principle. After implantation of the device, light sensitivity decreased markedly and the CDVA improved significantly, enabling the patient to discontinue contact lens use. Financial Disclosure Dr. C.L.C. Trindade holds a patent for the new device and has a license contract with Morcher GmbH. Dr. B.L.C. has no financial or proprietary interest in any material or method mentioned.