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First Author: A.Kachanov RUSSIA
Co Author(s): L. Balashevich S. Nikulin
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To investigate corneal ectasia after excimer laser surgery and estimate different risk factors of the post-op corneal ectasia in the 15-years follow-up period after LASIK.
Sv. Fyodorov IR&TC Eye Microsurgery, St.-Petersburg, Russia.
To studied more than 58500 cases (ca. 40000 patients) of our excimer laser surgery including LASIK (ca. 90%) and surface laser operations (PRK, LED, EpiLASIK on-flap) (ca. 10%). There were ca. 60% of women and 40% of men. Follow-up period was up to 15 years. We used MEL-60, MEL-70 and MEL-80 excimer laser (Carl Zeiss Meditec) and microkeratomes LSK-Evolution 1, 2 and 3 (Moria) for LASIK.
There was not corneal ectasia in the groups after surface corneal ablations (PRK, LED, EpiLASIK on-flap) and hyperopic LASIK (!). We have detected the post-op corneal ectasia in 23 patients (0,06%) in our investigation. The age of them was 28,6 ±6,8 years. 40 eyes (0,07%) had corneal ectasia after myopic LASIK only (!). Among them there were 10 eyes with previous radial keratotomy, 6 eyes with subclinical keratoconus and 24 eyes with normal cornea (0,05% of all myopic LASIK) in this group.
The risk factors of corneal ectasia after excimer laser surgery were the followings: increased vertical positive coma Z (3, 1) in WASCA and PENTACAM aberrometry, myopic LASIK procedure, preexisting subclinical keratoconus, previous anterior radial keratotomy, steep cornea with pre-op K > 44,0 D, and a very small residual stromal thickness in patients with high myopia and ultrathin cornea.