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Year : 2016  |  Volume : 17  |  Issue : 3  |  Page : 114-122

Various topographic patterns of post-LASIK ectasia and their treatment modalities

Department of Ophthalmology, Cairo University, Cairo, Egypt

Correspondence Address:
Sherif A Eissa
Kasr El Aini, 11451 Manial, Cairo
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1110-9173.195257

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Purpose The purpose of this study was to present different topographic presentations of keratectasia following laser in-situ keratomileusis (LASIK), and their management strategies. Settings The study was carried out in specialized eye hospital − Cornea and Refractive Unit. Design This is a retrospective case series. Patients and methods The study enrolled 44 eyes of 29 patients who presented with post-LASIK ectasia, between 2011 and 2014. Eight eyes (18.18%) had previous LASIK surgery at our center and 36 eyes (81.81%) had LASIK procedure by surgeons outside our hospital. Results Although 29 eyes (65.90%) presented early with crab-claw/pellucid-like pattern, only six eyes (13.63%) first presented with asymmetric bow tie with inferior steepening. Isolated inferior steep cone was the pattern in six eyes (13.63%), whereas three eyes (6.81%) presented early with superior steepness. Twenty-five eyes (56.81%) were managed by corneal collagen cross-linking (CXL) with riboflavin, followed 6 months later by toric implantable collamer lens in three eyes and implantable collamer lens in a single eye. Intracorneal ring segment implantation procedure was implemented in nine eyes (20.45%), whereas seven eyes (15.90%) had deep anterior lamellar keratoplasty done. Three patients − three eyes − (6.81%) refused treatment by cross-linking on early diagnosis, and they presented with progressive features of ectasia over 3 years, which finally required deep anterior lamellar keratoplasty. Conclusion Post-LASIK ectasia can manifest with various topographic patterns, at different onset points following LASIK, and unpredictable course of progression. Early diagnosis, proper discussion of the pros and cons of treatment modalities with the patient, and early intervention with the suitable corrective procedure is crucial.

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