Iatrogenic Ectasia after laser in situ

PURPOSE: Laser in situ keratomileusis (LASIK) has been associated with the development of postoperative corneal ectasia. We present a case of early onset ectasia after LASIK, review known risk factors in development, and discuss possible strategies for prevention. METHODS: A 39-year-old man underwent bilateral LASIK for moderate myopia. Preoperative cycloplegic refractions were -9.00 + 0.25 x 140 degrees OD and -7.75 sphere OS. Corneal topography demonstrated mild inferior steepening bilaterally although definite evidence of keratoconus by either the Klyce/Maeda and Smolek/Klyce keratoconus screening tests was not present...

PURPOSE: To study 13 eyes with less than -4.0 to -7.0 diopters of myopia that developed central or inferior keratectasia after laser in situ keratomileusis (LASIK). METHODS: The progress of the ectasia was determined by a series of pre- and post-LASIK topographies and the case histories. RESULTS: Progressive ectasia developed from 1 week to 27 months after LASIK. This necessitated the wearing of hard contact lenses or penetrating keratoplasty...

We present a case of unilateral iatrogenic keratectasia developing 10 months after bilateral laser in situ keratomileusis (LASIK) involving enhancement surgery using a broad-beam excimer laser (Summit Apex) to treat 6.6 diopters (D) of myopia. The ectasia progressed rapidly over the subsequent 12 months. The surgeon did not measure preoperative pachymetry, but preoperative topography and corneal measurements did not reveal underlying keratoconus or forme fruste keratoconus. Corneal transplantation was required for final visual rehabilitation...

We report an iatrogenic corneal ectasia that developed after laser in situ keratomileusis (LASIK) in a case of forme fruste keratoconus. One month postoperatively, corneal topography revealed a central steep area that showed rapid progression. Visual acuity in the eye decreased from 20/20 to 20/80. Corneas with forme fruste keratoconus may have altered biomechanical properties compared with normal corneas. Forme fruste keratoconus may be a contraindication for LASIK.