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Unilateral post-LASIK corneal ectasia with abnormal eye rubbing

Poster Details

First Author: H.Fukumitsu SPAIN

Co Author(s):    L. Arrevola   S. Miraflores                 

Abstract Details

Purpose:

To study corneal ectasia as it is the most feared complication of Laser in-situ Keratomileusis (LASIK), fortunately it is very rare, it consists of a thinning and a progressive increase in corneal curvature with a significant decrease in best-corrected visual acuity. Currently there is a method for assessing the risk of Post-LASIK ectasia, being the most important factor the corneal thickness. Furthermore, the development of a corneal ectasia with abnormal eye rubbing has been described very few times in the literature.

Setting:

This post-LASIK surgery case was observed in a teaching clinic with the most cutting edge technology and with the latest techniques for refractive surgery, during the post-operation check-up the patient was submitted to extensive corneal analysis with all the results being normal, all this in the most aseptic conditions possible

Methods:

We present a 32-year-old man intervened of LASIK in 2005 with a refractive defect of -2.00 myopic and cylinder -0.50 at 65 ° in right eye (OD) and -1.5 and cylinder -0.50 at 165 ° in left eye (OS). Among his personal history we can standout that he was a contact lens user. His ophthalmologic examination was normal, pachymetry of 555 µm in both eyes (OU) and elevation topography within normal limits. The flaps measured by intraoperative pachymetry were 80 µm, with a residual bed of 435 and 445 µm. Visual acuity without correction 2 years post-surgery was 20/20.

Results:

The patient returns to the clinic 6 years after the intervention because of decrease vision in OD. Referring as an only notable history a habit of reiterated rubbing of both eyes with predominance of the OD due to an episode of allergic conjunctivitis and chronic blepharitis. During ophthalmologic exploration it was observed a progressive Corneal Ectasia in OD, with a completely normal OS. Cross-linking is performed in OD with stabilization of the pathology.

Conclusions:

With this case we concluded that alteration in corneal hysteresis that can trigger an ectasia in a patient with excessive eye rubbing could be related to a shearing stress, an increase in temperature and a release of mediators of inflammation that can affect the metabolism of collagen of the cornea. Additionally, we think cross-linking is a safe technique for stabilization of this type of complication.

Financial Disclosure:

NONE

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