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Corneal ectasia after excimer laser corneal refractive procedure, analysis of cases and identification of risk factors

Poster Details

First Author: I.Irman Grcar SLOVENIA

Co Author(s):    M. Irman   R. Grcar                 

Abstract Details

Purpose:

To analyse medical records of patients who developed corneal ectasia after mechanical microkeratome or femtosecond laser-assisted laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK).

Setting:

Eye Clinic Irman, Zalec, Slovenia

Methods:

A retrospective review of cases that developed iatrogenic corneal ectasia after excimer laser corneal refractive procedure operated between 1996 and 2016 in one refractive surgery clinic was conducted. Preoperative and postoperative topographic or tomographic measurements were also examined. Risk factors for development of ectasia (including percent tissue altered (PTA)) were analysed.

Results:

Seven eyes of five patients with corneal ectasia after excimer laser refractive procedure were indentified. Two of five patients developed ectasia in both eyes. Five eyes of four patients developed corneal ectasia after LASIK. Two eyes of one patient developed corneal ectasia after PRK. This patient retrospectively revealed preoperative topography suggestive of forma fruste keratoconus. Mean age at time of surgery was 35 years. On average iatrogenic ectasia was diagnosed 7 years after procedure. Mean SE pre-operatively was -4, 78 dioptres. In three eyes enhancement was performed on later ectatic cornea. Average PTA was 26,5 % (range 11% - 46%).

Conclusions:

Iatrogenic ectasia is a rare complication of excimer laser corneal refractive procedure. In our group of patients iatrogenic ectasia was more prevalent in patients undergoing LASIK than PRK (especially microkeratome assisted LASIK/thicker flap), women, eyes that received enhancement procedure and eyes with retrospectively identified topography suggestive of forma fruste keratoconus.

Financial Disclosure:

NONE

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