Astigmatism Research Today is a free monthly online journal that collates and summarizes the latest research about Astigmatism, including details on cornea, retina, treatment, types, signs, tests.

Corneal ectasia after photorefractive keratectomy.

Leccisotti A

Ophthalmic Surgery Unit, Casa di Cura Rugani, Piazza 5° Bersaglieri 2, 53100, Siena, Italy, leccisotti@libero.it.

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.

Published 17 May 2007 in Graefes Arch Clin Exp Ophthalmol, 245(6): 869-875.
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