Corneal ectasia after photorefractive keratectomy |
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Authors: | Antonio Leccisotti |
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Institution: | (1) Ophthalmic Surgery Unit, Casa di Cura Rugani, Piazza 5° Bersaglieri 2, 53100 Siena, Italy |
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Abstract: | Background Corneal ectasia after photorefractive keratectomy (PRK) has only been occasionally reported, and its incidence has not been
assessed.
Methods In a retrospective, non-comparative case series, incidence of corneal ectasia was evaluated in a personal consecutive 6453-case
series of myopic PRK with a minimum follow-up of 18 months. Features and prognosis were evaluated in all patients with ectasia
after PRK (in both personal and referred cases).
Results Ectasia was detected in three eyes of two patients (patients 1 and 2) 3 years and 1 year after PRK performed elsewhere. In
addition, in the personal PRK series, two eyes of two patients (patients 3 and 4) developed corneal ectasia 5 months after
surgery (incidence: 0.03%). Pre-operatively, forme fruste keratoconus was present in patients 1, 3 and 4; keratoconus in the
fellow eye in patient 2; pachymetry <500 micron in patients 2 and 3. In patient 1, rigid contact lenses were prescribed, and
in patient 2 deep anterior lamellar keratoplasty was needed; in patients 3 and 4, low induced astigmatism resulted, requiring
driving spectacles in patient 3.
Conclusions PRK induced corneal ectasia in predisposed eyes, even after low myopic ablations. Forme fruste keratoconus and keratoconus
in the fellow eye were the main pre-operative findings. Prognosis varies according to severity.
The author has no financial or proprietary interest in any product or technique mentioned. The author has full control of
all primary data, and agrees to allow Graefes Archive for Clinical and Experimental Ophthalmology to review the data upon
request. |
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Keywords: | Photorefractive keratectomy Corneal ectasia Keratoconus |
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