Abstract
Purpose :
To describe the visual, refractive, and topographic outcomes of patients with late LASIK ectasia (LLE).
Methods :
Single-center, retrospective, observational, and longitudinal study of consecutive patients referred to our institution who were diagnosed with LLE. It was defined as ectasia occurring at least 2 years after LASIK for myopia was performed. Initial and last follow-up best-corrected visual acuity (BCVA), spherical equivalent (SE), corneal power (CP), minimum (Kmin) and maximum (Kmax) keratometries, and ectasia management were recorded. A comparative analysis between eyes with at least 4 months of follow-up managed with crosslinking (CXL) and with spectacles/contact lens (CL) was also performed.
Results :
Twenty-eight eyes from 20 patients (13 females and 7 males) were included. The mean age at LASIK treatment and at ectasia diagnosis was 26.1+5.1 and 37.7+7.1 years, respectively. Mean time between LASIK and onset of LLE was 11.8+5.5 years (range: 2–23 years). Twenty-one eyes with >4 months of follow-up were managed with CXL (76.2%, 16 eyes) and/or spectacles/CLs (23.8%, 5 eyes). At baseline, eyes managed with CXL had a worse SE (-5.3+4.4 vs. -1.4+2.2 D, p=0.048), and a nearly significant worse LogMAR BCVA (0.4+0.4 vs. 0.2+0.1, p=0.086) compared with the spectacle/CLs group. At the last follow-up (28.5+26.7 months; range: 4–94 months), eyes managed with CXL achieved a clinical improvement in BCVA, SE, and Kmax. No progression was noted in the spectacle/CLs group. No adverse events were reported.
Conclusions :
Refractive outcomes of patients diagnosed with late-onset LASIK ectasia treated with CXL and/or spectacles/CLs are comparable. CXL represents a safe and effective procedure to halt ectasia in patients with LLE. Further studies are warranted to develop standardized treatment protocols.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.