Corneal Ectasia after Photorefractive Keratectomy

Document Type : Case Report

Authors

1 Eye Research Center, Khatam-al-Anbia Eye Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

2 Ophthalmology Department, Razi Hospital, Birjand University of Medical Sciences, Birjand, Iran

Abstract

Two cases are presented with corneal ectasia after photorefractive keratectomy (PRK). Case 1 is a 24-year-old man with manifest refractions of -6.0 DS, -3.0 DC, axis 180° in the right eye and -4.50 DS, -4.0 DC, axis 160° in the left eye respectively with a symmetric bow-tie pattern bilaterally, without any evidence of keratoconus on corneal topography preoperatively. Ectasia occurred 10 months after surgery in the right eye.
Case 2 is a 20-year-old man with an attempted correction of −6.25 DS, -2.25 DC, axis 30° in the right eye, and −6.25 DS, −2.25 DC, axis 150° in the left eye. Thinnest central corneal thickness was 498µm and 499µm in the right and left eyes, respectively. Total ablation depth was 137 µm in the right eye and 136 µm in the left eye. 38 months after surgery ectasia developed in the left eye. Two patients had no family history suspicious for keratoconus.
Copyright: 2021 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Keywords


  1. Randleman JB, Russell B, Ward MA, Thompson KP, Stulting RD. Risk factors and prognosis for corneal ectasia after LASIK. Ophthalmology. 2003; 110(2):267-75. doi: 10.1016/S0161-6420(02)01727-X.
  2. Randleman JB, Stulting RD, Corneal ectasia. In Alio y Sanz JL, Azar DT. editors. Management of complications in refractive surgery. New York, NY: Springer 2008.
  3. Randleman JB, Caster AI, Banning CS, Stulting RD. m. J Cataract Refract Surg. 2006; 32(8):1395-8. doi: 10.1016/j.jcrs.2006.02.078.
  4. Marguerite B. McDonald, MD. Surgeon: LASIK involves far greater risk of postop ectasia than does PRK. 10 January 2011. Available from: https://www.healio.com/news/ophthalmology/20120331/surgeon-lasik-involves-far-greater-risk-of-postop-ectasia-than-does-prk.
  5. Seiler T, Koufala K, Richter G. Iatrogenic keratectasia after laser in situ keratomileusis. J Refract Surg. 1998;14(3):312-7. PMID: 9641422.
  6. Malecaze F, Coullet J, Calvas P, Fournié P, Arné JL, Brodaty C. Corneal ectasia after photorefractive keratectomy for low myopia. Ophthalmology. 2006; 113(5):742-6. doi: 10.1016/j.ophtha.2005.11.023.
  7. Parmar D, Claoué C. Keratectasia following excimer laser photorefractive keratectomy. Acta Ophthalmol Scand. 2004; 82(1):102-5. doi: 10.1111/j.1395-3907.2003.0189b.x. 
  8. Holland SP, Srivannaboon S, Reinstein DZ. Avoiding serious corneal complications of laser assisted in situ keratomileusis and photorefractive keratectomy. Ophthalmology. 2000; 107(4):640-52. doi: 10.1016/s0161-6420(99)00131-1.  
  9. Kim H, Choi JS, Joo CK. Corneal ectasia after PRK: clinicopathologic case report. Cornea. 2006; 25(7):845-8. doi: 10.1097/01.ico.0000224634.72309.43. 
  10. Leccisotti A. Corneal ectasia after photorefractive keratectomy. Graefes Arch Clin Exp Ophthalmol. 2007; 245(6):869-75. doi: 10.1007/s00417-006-0507-z.
  11. Mortensen JN. Corneal ectasia after PRK. Int J Keratoco Ectatic Corneal Dis. 2012;1(1):73-74. doi: 10.5005/jp-journals-10025-1014.
  12. Hashemian MN, Alizadeh M, Hashemi H, Rahimi F, Management of unpredictable post-PRK corneal ectasia with intacs implantation. Iranian Journal of Ophthalmology 2009; 21(3):63-70.