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S. Fermon, A. Navas, A. Narvaez, A. Haber, R. Suarez; Ectasia Post–Photorefractive Keratectomy (PRK). Case Report . Invest. Ophthalmol. Vis. Sci. 2006;47(13):1313.
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To describe the clinical features and outcome of a patient who presented ectasia post–photorefractive keratectomy (PRK)
A 35–year old healthy man who had bilateral photorefractive keratectomy 3 months ago and presented ectasia post–PRK without any tangible risk factor.
Preoperatively, uncorrected visual acuity (UCVA) was 20/200 with a refraction of –3.00 –1.50 × 20 in the right eye and –3.00 –2.00 × 160 in the left eye. The best corrected visual acuity (BCVA) of 20/20 in both eyes. Measured by Orbscan, the scotopic pupil diameter was 3.8 mm in the right eye and 4.3 mm in the left eye. Corneal thickness measured by ultrasound was 497 µm and 511 µm, respectively. The PRK was performed uneventfully (8.0 mm trephine) after 30 seconds of 20% alcohol exposure with a 5.0 and 5.5 mm optical zone respectivly using a Technolas 217 excimer laser (Bausch & Lomb). Ablation depth was 67 µm in the right eye and 70 µm in the left eye. After 3 days, the epithelium was fully recovered and the soft contact lenses were removed. The uncorrected visual acuity was 20/50 bilateral. Two weeks after surgery, reports a loss in visual acuity in both eyes, The UCVA was 20/80 in the right eye and 20/200 in the left eye. and the BCVA, 20/25 with contact lens. Slitlamp examination revealed a inferotemporally thinning of the corneal stroma. Topographic images are shown. These complaints and the topographic findings are consistent with a diagnosis of post–PRK corneal ectasia.
To our knowledge the ectasia as a complication of photorefractive keratectomy (PRK) is extremely rare, and we find very interesting the time between surgery and the development of the complication. Interestingly after reviewing the family we found a sister with clinical and topographic keratoconus. We strongly recommend perform topografic studies to the members of the family with ametropic errors of patients who wants refractive surgery in order to find suspicious studies before the procedure.
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