Lasik induced ectasia

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...

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...

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...

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...

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...

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...

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...

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...

PURPOSE: To describe a new technique and early outcomes of combined intrastromal corneal ring segment (ICRS) insertion and laser in situ keratomileusis (LASIK) to treat patients with moderate to high myopia and thin corneas. SETTING: University-based academic practice, Boston, Massachusetts, USA. METHODS: Combined ICRS insertion and LASIK was performed in 2 stages: ICRS channel formation (stage I) followed by LASIK and ICRS insertion (stage II)...

PURPOSE: To review the time course of corneal anteroposterior shift and refractive stability after myopic excimer laser keratorefractive surgery. METHODS: We examined 65 eyes undergoing photorefractive keratectomy (PRK) and 45 eyes undergoing laser in situ keratomileusis (LASIK). Corneal elevation maps and pachymetry were obtained by scanning-slit corneal topography before; 1 week; and 1, 3, 6, and 12 months after surgery. RESULTS: Both PRK and LASIK induced significant forward shifts of the cornea...

PURPOSE: To identify factors that can lead to corneal ectasia after laser in situ keratomileusis (LASIK). SETTING: University refractive surgery center. METHODS: In this retrospective study, the charts of all patients (2873 eyes) who had LASIK between May 1995 and November 1999 were reviewed. Fourteen patients (19 eyes, 0.66%) developed post-LASIK ectasia. The mean follow-up was 16.32 months (range 6 to 42 months). RESULTS: No patient with an attempted correction less than 8...

Proper preoperative evaluation is critical for avoiding many postoperative complications associated with laser in-situ keratomileusis (LASIK). Proper nonsurgical management includes careful monitoring of patients during the recovery period using various testing procedures, including corneal topography. When surgical intervention is required, a stepwise approach often is used as a conservative treatment, allowing further treatment if necessary. Many complications after LASIK are amenable to further treatment...

PURPOSE: To analyze the results of secondary laser in situ keratomileusis (LASIK) for residual myopia after primary LASIK. SETTING: Dr. Agarwal's Eye Hospital, Chennai, India. METHODS: A retrospective study of 50 eyes of 29 patients who had a secondary LASIK procedure was carried out. After a mean follow-up of 5.84 months +/- 3.24 (SD) after the primary procedure, the mean myopic residual refraction was -4.30 +/- 1.83 diopters (D). In 10 eyes, the primary corneal flap was lifted by blunt dissection...

PURPOSE: Ectasia after laser in situ keratomileusis (LASIK) is a rare but serious complication. Prevention includes proper patient selection with detection of those at particular risk. Causes of ectasia include predisposition, excessive ablation with less than 250 microm of residual stromal bed, thicker than normal flap, irregular corneal thickness, and different ablation rates. METHODS: We evaluated corneal curvature patterns and their relationship to corneal topography and pachymetry maps...

PURPOSE: Corneal thinning disorders weaken the mechanical strength of affected corneas, suggesting that photorefractive procedures may be contraindicated in keratoconus. Few cases have been reported to confirm this hypothesis. METHODS: A 45-year-old man had two laser in situ keratomileusis (LASIK) procedures and one photorefractive keratectomy (PRK) performed on his left eye, and three LASIK procedures on his right eye. After these surgeries, a dramatic corneal ectasia and grade III haze occurred in both eyes, with a clinical diagnosis of keratoconus...