Bilateral Corneal Ectasia 7 Years After Lasik Challenging Fundamental Concepts

Published 2022 - 40th Congress of the ESCRS

Reference: PO061 | Type: Case report | DOI: 10.82333/kxg9-kn22

Authors: Suphi Taneri* ¹ , Guy Kezirian ² , Anika Rost ³ , H. Burkhard Dick ⁴

¹Eye department of St. Francis Hospital Muenster,Center for Refractive Surgery Muenster,Münster,Germany;Ruhr-University,Bochum,Germany, ²SurgiVision,Scottsdale,United States, ³Eye department of St. Francis Hospital Muenster,Center for Refractive Surgery Muenster,Münster,Germany, ⁴Ruhr-University,Bochum,Germany

To present a case of corneal ectasia that challenges two concepts of iatrogenic ectasia induction after LASIK

Center for Refractive Surgery, Eye Department at St. Francis Hospital Muenster, Germany.

A 30 yo male patient was screened at our institution for laser vision correction in 2014 with a refraction of OD -3.5 -1.5 x89° =1.25 and OS -4.0 -1.5 x93° =1.25. As his Orbscan and Zywave scans were normal LASIK was deemed suitable.

However, he underwent LASIK in another clinic with excellent initial outcomes and was satisfied for several years with the result. In June 2021, he was referred to us because of increasing astigmatism OU. He still had no known allergies and denied eye-rubbing. We found an ectatic cornea OU on tomography with typical thinning and protrusion in the infero-temporal quadrant typical of a keratoconic cornea without prior surgical intervention.

In both eyes, ectasia occurred not at the thinnest point of the cornea after LASIK but in the typical location (infero-temporal) for keratoconus in untreated eyes. This challenges the assumption that the thinnest point of the postoperative cornea is its weakest point and the likely locus for ectasia development. The concepts of residual stromal bed and percent tissue altered are based on this fundamental assumption.