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JB Randleman, JY Freeman, B Russell, MA Ward, KP Thompson, RD Stulting; Risk Factors and Prognosis for Corneal Ectasia after LASIK . Invest. Ophthalmol. Vis. Sci. 2002;43(13):2098.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To review cases of keratectasia developing after LASIK, identify pre-operative risk factors, and compare these results to the cumulative literature. Methods: Design: Retrospective Comparative Study. Participants: Ten eyes from seven patients presenting to the Emory Eye Center Contact Lens Department identified as developing ectasia after LASIK. Methods: Pre-operative data, operative notes, and post-operative course data were retrospectively collected for each case. Fifteen patients with keractasia were identified. Preoperative data was obtainable on 10 of them, which are the subjects of this report. Results: Mean follow up was 23.4 months (range 6-48 months). Mean time to the development of ectasia was 16.3 months (range 1-45 months). Over 70% of eyes exhibited features of FFKC preoperatively. More than one half of the cases had greater than 8 diopters of myopia pre-operatively, and 50% had RSB less than 250 microns. Enhancements occurred in 77% of cases. Only 10% lost more than one line of BCVA, and all patients eventually achieved 20/30 or better vision. One case required penetrating keratoplasty (10%), while all others were corrected with RGP contact lenses. Conclusion: Risk factors for the development of ectasia following LASIK include FFKC, myopia greater than 8 diopters, and residual stromal bed less than 250 microns thick. All patients had at least one of these risk factors pre-operatively. Multiple enhancements were also associated with the development of keratectasia. Most patients (90%) achieved 20/30 or better vision with RGP contact lenses.
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