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my personal edition > cornea > news
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DGReview
Risk Factors Identified For Corneal Ectasia After LASIK
A DGReview of :"Risk factors and prognosis for corneal ectasia after LASIK."
Ophthalmology
03/03/2003
By Mark Greener
High myopia, forme fruste keratoconus and thin residual stromal beds are risk factors for corneal ectasia after laser in situ keratomileusis (LASIK).
JB Randleman and colleagues from Emory University, Atlanta, Georgia, United States, retrospectively analysed 10 eyes from seven patients who developed corneal ectasia after LASIK. The authors also enrolled 33 patients who previously developed ectasia as well as two control groups: the first control group consisted of 100 patients with uneventful LASIK and normal postoperative courses, the second control group had 100 cases who showed high preoperative myopia of more than 8 dioptres (D).
Follow-up after LASIK lasted an average of 23.4 months, but ranged from 6 to 48 months. Corneal ectasia developed in a mean of 16.3 months, although this ranged from 1 to 45 months. Preoperative refraction in patients that developed post-LASIK ectasia averaged -8.69 D. This compared to -5.37 D for controls with uneventful LASIK.
Before LASIK, 88% of patients that developed ectasia following LASIK showed forme fruste keratoconus. This compared to 2% of controls with uneventful LASIK and 4% of the controls with high preoperative myopia.
Seventy percent of post-LASIK ectasia patients showed residual stromal bed thickness of <250 micro m. This compared to 16 and 46% of the controls with uneventful LASIK and those with high preoperative myopia respectively. On average, the residual stromal bed was thinner the post-LASIK ectasia patients than either control groups.
Seventy percent of eyes showed enhancements. Only 10% lost more than one line of final best-corrected visual acuity. All patients eventually achieved corrected vision of at least 20/30. One eye required penetrating keratoplasty. Rigid gas-permeable contact lenses were used for correction in the other cases.
The authors commented that all patients that developed post-LASIK ectasia showed at least one risk factor other than myopia. Indeed, significant differences remained between the groups even after the authors controlled for myopia. No patient "developed ectasia without recognizable preoperative risk factors."
Ophthalmology 2003;110:2:267-75.
"Risk factors and prognosis for corneal ectasia after LASIK."
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