ESCRS - PO060 - To Report An Unusual Case Of Unilateral Post Lasik Ectasia 7-8 Years After Surgery And Without Any Apparent Reason Or Risk Factors.

To Report An Unusual Case Of Unilateral Post Lasik Ectasia 7-8 Years After Surgery And Without Any Apparent Reason Or Risk Factors.

Published 2022 - 40th Congress of the ESCRS

Reference: PO060 | Type: Case report | DOI: 10.82333/vr9f-rc06

Authors: Ronak Solanki* 1

1Refractive Surgery,Neoclarity Eye and Dental Care,Mumbai,India

An unusual case report on post LASIK ectasia diagnosed in a young patient 7-8 years after surgery and without any apparent reason or risk factors and the importance of history, ruling out other causes of post lasik refractive error along with a safe approach in cases with good visual acuity.

Neoclarity Eye & Dental Care Hospital, Mumbai. 

A 30 year-old male patient presented to us with Diminution of vision for 2 years. He had a stable refraction for the first 7-8 years after surgery. At presentation his BCDVA was OD Plano 20/20 and OS 20/30 with -3.25DS/-0.50DC@40. He has history of Optical shop prescription 2 years back of OD plano 20/20 and OS -2.50DS/-0.50DC@45. No Preoperative records are available with patient except his history of Lasik at 19-20 years of age, approximate preoperative power of 1-2 D in OD and 5-6 D in OS based on his history, soft contact lens use for 1 year occasionally before surgery for 1 year. Randelman Risk score could not be established just on history. He had undergone microkeratome blade-LASIK. No history of Eye rubbing was given. On Clinical evaluation his Anterior segment showed Developmental lamellar cataract both eyes same pattern, lasik flap scar both eyes and rest anterior segment and fundus evaluation was within normal limits. Pentacam Corneal Topography showed OD Q-0.58 thinnest pachymetry 521 microns, Sagittal maps normal, no I-S variations and Posterior elevation of +18. OS showed Q +0.05, thinnest pachymetry 462 microns, I-S variation, Sagittal map changes, Posterior Elevation +22 and BADD display changes . Axial length OD 22.48 / OS 25.46 on IOL Master 700 to confirm history of anisometropia before surgery.

Suspicion for Unilateral Post Lasik Ectasia without any obvious risk factors was thought for as a diagnosis and decision to wait for corneal cross linking (CXL) treatment was done since patient had a good visual acuity , no previous records and no clarity of a progressive nature of the changes on history and tomography.

A careful look into previous history, eliminating all other possible causes of Post Lasik refractive errors along with documenting progression on topography for Post lasik ectasia before planning for crosslinking treatment may be the best approach in patients with good visual acuity.