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Corneal ectasia after photorefractive keratectomy

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Abstract

Background

Corneal ectasia after photorefractive keratectomy (PRK) has only been occasionally reported, and its incidence has not been assessed.

Methods

In a retrospective, non-comparative case series, incidence of corneal ectasia was evaluated in a personal consecutive 6453-case series of myopic PRK with a minimum follow-up of 18 months. Features and prognosis were evaluated in all patients with ectasia after PRK (in both personal and referred cases).

Results

Ectasia was detected in three eyes of two patients (patients 1 and 2) 3 years and 1 year after PRK performed elsewhere. In addition, in the personal PRK series, two eyes of two patients (patients 3 and 4) developed corneal ectasia 5 months after surgery (incidence: 0.03%). Pre-operatively, forme fruste keratoconus was present in patients 1, 3 and 4; keratoconus in the fellow eye in patient 2; pachymetry <500 micron in patients 2 and 3. In patient 1, rigid contact lenses were prescribed, and in patient 2 deep anterior lamellar keratoplasty was needed; in patients 3 and 4, low induced astigmatism resulted, requiring driving spectacles in patient 3.

Conclusions

PRK induced corneal ectasia in predisposed eyes, even after low myopic ablations. Forme fruste keratoconus and keratoconus in the fellow eye were the main pre-operative findings. Prognosis varies according to severity.

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References

  1. Pallikaris IG, Kymionos GD, Astyrakakis NI (2001) Corneal ectasia induced by laser in situ keratomileusis. J Cataract Refract Surg 27:1796–1802

    Article  PubMed  CAS  Google Scholar 

  2. Randleman JB, Russell B, Ward MA, Thompson KP, Stulting RD (2003) Risk factors and prognosis for corneal ectasia after LASIK. Ophthalmology 110:267–275

    Article  PubMed  Google Scholar 

  3. Rao SN, Epstein RJ (2002) Early onset ectasia following laser in situ keratomileusis: case report and literature review. J Refract Surg 18:177–184

    PubMed  Google Scholar 

  4. Geggel HS, Talley AR (1999) Delayed onset keratectasia following laser in situ keratomileusis. J Cataract Refract Surg 25:582–586

    Article  PubMed  CAS  Google Scholar 

  5. Doyle SJ, Hynes E, Naroo S, Shah S (1996) PRK in patients with a keratoconic topography picture. The concept of a physiological ‘displaced apex syndrome’. Br J Ophthalmol 80:25–28

    PubMed  CAS  Google Scholar 

  6. Bilgihan K, Ozdek SC, Konuk O, Akata F, Hasanreisoglu B (2000) Results of photorefractive keratectomy in keratoconus suspects at 4 years. J Refract Surg 16:438–443

    PubMed  CAS  Google Scholar 

  7. Lovisolo CF, Fleming JF (2002) Intracorneal rings segments for iatrogenic keratectasia after laser in situ keratomileusis or photorefractive keratectomy. J Refract Surg 18:535–541

    PubMed  Google Scholar 

  8. Parmar D, Claoue C (2004) Keratectasia following excimer laser photorefractive keratectomy. Acta Ophthalmol Scand 82:102–105

    Article  PubMed  Google Scholar 

  9. Chiou AG, Bovet J, de Courten C (2006) Management of corneal ectasia and cataract following photorefractive keratectomy. J Cataract Refract Surg 32:679–680

    Article  PubMed  Google Scholar 

  10. Malecaze F, Coullet J, Calvas P, Fournié P, Arné JL, Brodaty C (2006) Corneal ectasia and after photorefractive keratectomy for low myopia. Ophthalmology 13:742–746

    Article  Google Scholar 

  11. Holland SP, Srivannaboon S, Reinstein DZ (2000) Avoiding serious corneal complications of laser assisted in situ keratomileusis and photorefractive keratectomy. Ophthalmology 107:640–652

    Article  PubMed  CAS  Google Scholar 

  12. Randleman JB, Caster AI, Banning CS, Stulting RD (2006) Corneal ectasia after photorefractive keratectomy. J Cataract Refract Surg 32:1385–1398

    Article  Google Scholar 

  13. Comaish IF, Lawless MA (2002) Progressive post-LASIK keratectasia. Biomechanical instability or chronic disease process? J Cataract Refract Surg 28:2206–2213

    Article  PubMed  Google Scholar 

  14. Rao SK, Srinivasan B, Sitalakshmi G, Padmanabhan P (2004) Photorefractive keratectomy versus laser in situ keratomileusis to prevent keratectasia after corneal ablation. J Cataract Refract Surg 30:2623–2628

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Ophthalmic Surgery Unit, Casa di Cura Rugani, Piazza 5° Bersaglieri 2, 53100, Siena, Italy

    Antonio Leccisotti

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  1. Antonio Leccisotti
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Correspondence to Antonio Leccisotti.

Additional information

The author has no financial or proprietary interest in any product or technique mentioned. The author has full control of all primary data, and agrees to allow Graefes Archive for Clinical and Experimental Ophthalmology to review the data upon request.

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Leccisotti, A. Corneal ectasia after photorefractive keratectomy. Graefe's Arch Clin Exp Ophthalmol 245, 869–875 (2007). https://doi.org/10.1007/s00417-006-0507-z

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  • DOI: https://doi.org/10.1007/s00417-006-0507-z

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