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Lasik induced ectasia

Jessica Y Tong, Deepa Viswanathan, Christopher Hodge, Gerard Sutton, Colin Chan, John J Males
PURPOSE: Post laser-assisted in situ keratomileusis (LASIK) ectasia is a rare and unpredictable complication after LASIK. Corneal collagen crosslinking (CXL) has emerged as a promising technique to address this complication. Our study evaluates the long-term efficacy of CXL for post-LASIK ectasia in an Australian setting. DESIGN: Retrospective review of post-LASIK ectasia patients referred to and treated at 3 corneal refractive surgery institutions in Sydney, Australia...
May 2017: Asia-Pacific Journal of Ophthalmology
Roy S Rubinfeld, Rachel H Epstein, Parag A Majmudar, Deborah Kim, Michael Choi, Randy J Epstein
A 41-year-old man presented 10 years after uneventful laser in situ keratomileusis (LASIK) with symptomatic post-LASIK ectasia. He had treatment with the classic Dresden epithelium-off technique and presented 4 years later with progression of the ectasia. He was subsequently retreated with conductive keratoplasty (CK) followed by a new proprietary epithelium-on corneal collagen crosslinking (CXL) procedure using a proprietary transepithelial riboflavin formulation and delivery system on the following day...
January 2017: Journal of Cataract and Refractive Surgery
Apostolos Lazaridis, Dan Z Reinstein, Timothy J Archer, Stephan Schulze, Walter Sekundo
PURPOSE: To design a technique for intrastromal transplantation of stromal lenticules with specific refractive power for correction of post-LASIK induced hyperopia and astigmatism. METHODS: A 28-year-old patient was referred for consultation after complicated LASIK for moderate myopia and astigmatism. The refractive error of the right eye was severely overcorrected due to data entry error. Post-LASIK refraction showed high astigmatism (right eye: +6.50 -9.00 @ 84°) and corrected distance visual acuity (CDVA) of 20/32...
November 1, 2016: Journal of Refractive Surgery
L Jouve, V Borderie, C Temstet, A Labbé, L Trinh, O Sandali, E Basli, L Laroche, N Bouheraoua
Corneal collagen crosslinking (CXL) is, at present, the only treatment that can slow or even stop the progression of keratoconus. It uses riboflavin and ultraviolet A (UVA) to create covalent bonds ("crosslinks") between collagen fibrils thus increasing corneal rigidity. Although to date there has been no direct evidence of intrastromal corneal crosslinking, several studies have reported the safety and efficacy of the conventional CXL protocol. This protocol is indicated for progressive keratoconus with a minimal corneal thickness (without the epithelium) of at least 400 μm...
May 2015: Journal Français D'ophtalmologie
Marcony R Santhiago, David Smadja, Steven E Wilson, Ronald R Krueger, Mario L R Monteiro, J Bradley Randleman
PURPOSE: To investigate the association of the percent tissue altered (PTA) with the occurrence of ectasia after LASIK in eyes with suspicious preoperative corneal topography. METHODS: This retrospective comparative case-control study compared associations of reported ectasia risk factors in 129 eyes, including 57 eyes with suspicious preoperative Placido-based corneal topography that developed ectasia after LASIK (suspect ectasia group), 32 eyes with suspicious topography that remained stable for at least 3 years after LASIK (suspect control group), and 30 eyes that developed ectasia with bilateral normal topography (normal topography ectasia group)...
April 2015: Journal of Refractive Surgery
Cosimo Mazzotta, Angelo Balestrazzi, Claudio Traversi, Stefano Caragiuli, Aldo Caporossi
We report the first pilot qualitative confocal microscopic analysis of a laser in situ keratomileusis (Lasik) treatment combined with sequential high-fluence accelerated corneal collagen cross-linking, denominated Lasik XTra, by means of HRT II laser scanning in vivo confocal microscopy after a 6-month follow-up. After obtaining approval from the Siena University Hospital Institutional Review Board, a 33-year-old female patient underwent a Lasik XTra procedure in her left eye. Confocal analysis demonstrated induced slight corneal microstructural changes by the interaction between UV-A, riboflavin and corneal stromal collagen, beyond the interface to a depth of 160 µm, without adverse events at the interface and endothelial levels...
January 2014: Case Reports in Ophthalmology
Nir Sorkin, David Varssano
Keratoconus (KCN) is an ectatic disorder with progressive corneal thinning and a clinical picture of corneal protrusion, progressive irregular astigmatism, corneal fibrosis and visual deterioration. Other ectatic corneal disorders include: post-LASIK ectasia (PLE) and pellucid marginal degeneration (PMD). Corneal crosslinking (CXL) is a procedure whereby riboflavin sensitization with ultraviolet A radiation induces stromal crosslinks. This alters corneal biomechanics, causing an increase in corneal stiffness...
2014: Ophthalmologica. Journal International D'ophtalmologie
Jacqueline Martins Sousa, Flavio Eduardo Hirai, Elcio Hideo Sato
Keratoconus has usually been described as bilateral but asymmetric disease. Corneal ectasia is one of the long-term complications of modern refractive surgery, especially those submitted to laser in situ keratomileusis (LASIK). We describe a patient with keratoconus in the right eye that was submitted to radial keratectomy (RK) in the left eye 19 years ago with no progression of the ectatic cornea and no complications related to the refractive surgery. Because unilateral keratoconus is rare, we believe that RK was performed on an already ectatic cornea (not clinically detected) or with fruste keratoconus...
May 2013: Arquivos Brasileiros de Oftalmologia
(no author information available yet)
OBJECTIVE: The purpose of this project was to determine the role of corneal implants in the management of corneal thinning disease conditions. An evidence-based review was conducted to determine the safety, effectiveness and durability of corneal implants for the management of corneal thinning disorders. The evolving directions of research in this area were also reviewed. SUBJECT OF THE EVIDENCE-BASED ANALYSIS: The primary treatment objectives for corneal implants are to normalize corneal surface topography, improve contact lens tolerability, and restore visual acuity in order to delay or defer the need for corneal transplant...
2009: Ontario Health Technology Assessment Series
Thu-Mai Nguyen, Jean-François Aubry, David Touboul, Mathias Fink, Jean-Luc Gennisson, Jeremy Bercoff, Mickael Tanter
PURPOSE: Keratoconus disease or post-LASIK corneal ectasia are increasingly treated using UV-A/riboflavin-induced corneal collagen cross-linking (CXL). However, this treatment suffers from a lack of techniques to provide an assessment in real-time of the CXL effects. Here, we investigated the potential interest of corneal elasticity as a biomarker of the efficacy of this treatment. METHODS: For this purpose, supersonic shear wave imaging (SSI) was performed both ex vivo and in vivo on porcine eyes before and after CXL...
August 2012: Investigative Ophthalmology & Visual Science
Marine Hovakimyan, Rudolf F Guthoff, Oliver Stachs
Collagen cross-linking (CXL) using UVA light and riboflavin (vitamin B2) was introduced as a clinical application to stabilize the cornea by inducing cross-links within and between collagen fibers. CXL has been investigated extensively and has been shown clinically to arrest the progression of keratoconic or post-LASIK ectasia. With its minimal cost, simplicity, and proven positive clinical outcome, CXL can be regarded as a useful approach to reduce the number of penetrating keratoplasties performed. Small case series have also indicated that CXL is beneficial in corneal edema by reducing stromal swelling behavior and in keratitis by inhibiting pathogen growth...
2012: Journal of Ophthalmology
C D Reilly, V Panday, V Lazos, B R Mittelstaedt
INTRODUCTION: The field of refractive surgery continues to evolve amid continued concerns as to which surgical technique minimizes the risk of inducing ectasia. PURPOSE: To compare clinical outcomes between PRK, LASEK and Epi-LASIK in moderately to highly myopic eyes (-4.00 D to -8.00 D). MATERIALS AND METHODS: A retrospective chart review of 100 PRK eyes, 100 LASEK eyes (with alcohol) and 97 Epi-LASIK eyes was performed. Post-operative pain, uncorrected visual acuity, and corneal haze data was recorded and analyzed at post-op days 1, 4 and 7 and at post-op months 1, 3, 6 and 12...
July 2010: Nepalese Journal of Ophthalmology
Teresa Fernández Peinado, David P Piñero, Ignacio Alcaraz López, Jorge L Alio
We report a case of corneal ectasia in a 25-year-old man after myopic laser in situ keratomileusis in which a complete characterization of the corneal structure was performed by means of a Scheimpflug photography-based system. The patient presented in the ectatic eye with a subjective refraction of +0.50 to 6.00 × 100°, which with correction gave a visual acuity of 20/25. With the topographic analysis, corneal shapes from both corneal surfaces at the four different quadrants were found to be complementary, maintaining the meniscus-shaped profile of the cornea...
April 2011: Optometry and Vision Science: Official Publication of the American Academy of Optometry
Anastasios John Kanellopoulos, Perry S Binder
PURPOSE: To evaluate a series of patients with corneal ectasia after LASIK that underwent the Athens Protocol: combined topography-guided photorefractive keratectomy (PRK) to reduce or eliminate induced myopia and astigmatism followed by sequential, same-day ultraviolet A (UVA) corneal collagen cross-linking (CXL). METHODS: Thirty-two consecutive corneal ectasia cases underwent transepithelial PRK (WaveLight ALLEGRETTO) immediately followed by CXL (3 mW/cm(2)) for 30 minutes using 0...
May 2011: Journal of Refractive Surgery
Juan-Carlos Abad
Two cases of intrastromal corneal ring (Intacs, Addition Technology) implantation to treat post-laser in situ keratomileusis (LASIK) ectasia developed progressive slippage of the flap over the stromal bed, resulting in progressive flattening of the affected meridian. The flattening was thought to have occurred because the poorly healed flap edge could not withstand the change in corneal shape induced by the ring segments. The flap was lifted, debris was removed, and the flap was sutured to the residual stromal bed using interrupted 10-0 nylon sutures passed through two thirds of the cornea...
December 2008: Journal of Cataract and Refractive Surgery
George D Kymionis, Dimitrios I Bouzoukis, Vasilios F Diakonis, Dimitra M Portaliou, Aristofanis I Pallikaris, Sonia H Yoo
A 27-year-old man presented with corneal ectasia in his left eye 4 years after myopic laser in situ keratomileusis (LASIK) and was treated with riboflavin-ultraviolet-A (crosslinking). During the first post-treatment days, diffuse lamellar keratitis (DLK) (stage III) developed. The microbiology culture was negative. After intensive treatment with topical corticosteroids, the DLK resolved during the following 2 weeks. Crosslinking for post-LASIK corneal ectasia may induce DLK. Early diagnosis and appropriate treatment with intensive topical corticosteroids is essential to successfully manage this post-crosslinking complication...
December 2007: Journal of Cataract and Refractive Surgery
Ali A Mearza, Fedra N Koufaki, Ioannis M Aslanides
PURPOSE: To report a case of airbag induced corneal ectasia. METHODS: Case report. RESULTS: A patient 3 years post-LASIK developed bilateral corneal ectasia worse in the right eye following airbag deployment in a road traffic accident. At last follow up, best corrected vision was 20/40 with -4.00/-4.00 x 25 in the right eye and 20/25 with -1.25/-0.50 x 135 in the left eye. CONCLUSIONS: This is a rare presentation of trauma induced ectasia in a patient post-LASIK...
February 2008: Contact Lens & Anterior Eye: the Journal of the British Contact Lens Association
Almamoun Abdelkader, Salomon Esquenazi, Wisam Shihadeh, Haydee E P Bazan, Jiucheng He, Steve Gill, Herbert E Kaufman
PURPOSE: Post-laser in situ keratomileusis (LASIK) corneal ectasia is a progressive deformation of the gross corneal anatomy that occurs after surgery. However, this is a rare event even after deep lamellar keratoplasty. We hypothesize that the strength of the lamellar keratoplasty wound is derived from the sutures that enhance the wound edge healing response. This study compares, in a rabbit model, the stability of previously sutured and unsutured microkeratome flaps. METHODS: Unilateral 160-micro m-thick LASIK flaps using a mechanical microkeratome was performed in 20 rabbit eyes...
November 2006: Current Eye Research
M C Knorz
In surface ablation, haze is the most frequent complication. After LASIK, microkeratome-related complications are rare today and usually resolve without sequelae, provided no ablation was done. Postoperative flap complications such as flap slippage usually occur during the first few days after surgery and should be treated as early whenever present. Interface complications are a new diagnostic entity as the interface between flap and stroma presents a space where fluid or cells can accumulate. Diffuse lamellar keratitis usually occurs within the first few postoperative days and should be treated aggressively to avoid scarring...
March 2006: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
Hyojin Kim, In Kyung Song, Choun-Ki Joo
PURPOSE: To describe the morphological features of a prominent ectasia of the cornea after laser in situ keratomileusis (LASIK). METHODS: The morphology of the ectatic corneas was examined using corneal topography, light microscopy and transmission electron microscopy in 2 cases who underwent penetrating keratoplasty due to poor visual acuity induced by progressive corneal ectasia after LASIK. RESULTS: On topographic examination, the apex of the corneal surface was observed within the central 3-mm zone, and the smallest thickness was 0...
2006: Ophthalmologica. Journal International D'ophtalmologie
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