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Corneal ectasia after photorefractive keratectomy
J Bradley Randleman1, Andrew I Caster, Christopher S Banning
1Emory University Department of Ophthalmology and Emory Vision, Atlanta, Georgia 30322, USA. jrandle@emory.edu
Journal of Cataract and Refractive Surgery
|July 26, 2006
Summary
Corneal ectasia, a serious complication, can occur after photorefractive keratectomy (PRK). This study highlights two cases where patients developed this condition, emphasizing the need for careful patient selection and risk assessment before PRK surgery.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Refractive Surgery
Background:
- Photorefractive keratectomy (PRK) is a common refractive surgery procedure.
- Corneal ectasia is a rare but severe complication following refractive surgery.
- Identifying pre-operative risk factors is crucial for patient safety.
Observation:
- Two patients developed bilateral corneal ectasia after undergoing PRK.
- Case 1 presented with pre-operative signs of early keratoconus, including thin corneas and topographical steepening.
- Case 2 had high myopia, borderline corneal thickness, and a family history suggestive of keratoconus.
Findings:
- Both patients exhibited significant refractive errors and specific topographical patterns indicative of corneal irregularities.
- Post-PRK, both patients progressed to develop corneal ectasia, a condition characterized by progressive corneal thinning and bulging.
- The cases underscore the potential for ectasia development even in the presence of pre-existing, subclinical keratoconus or a genetic predisposition.
Implications:
- These findings suggest that PRK may carry a risk of inducing or exacerbating corneal ectasia in susceptible individuals.
- Enhanced pre-operative screening, including advanced corneal imaging and family history assessment, is vital for identifying high-risk patients.
- Ophthalmologists should carefully weigh the risks and benefits of PRK in patients with potential risk factors for corneal ectasia.
