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Ectasia after laser in situ keratomileusis
1Ophthalmology Research, Cedars-Sinai Medical Center and Department of Ophthalmology, UCLA School of Medicine, Los Angeles, California 90048, USA. rabinowitzy@cshs.org
Current Opinion in Ophthalmology
|August 26, 2006
Summary
Ectasia after laser in situ keratomileusis (LASIK) is a growing concern. Research highlights limitations in current diagnostic technology and proposes new insights into corneal biomechanics to minimize risks.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Refractive Surgery
Background:
- Increased litigation concerns have spurred interest in ectasia following laser in situ keratomileusis (LASIK).
- Current understanding of ectasia pathogenesis and risk factors is evolving.
Purpose of the Study:
- To summarize recent research on ectasia after LASIK.
- To provide guidelines for minimizing the risk of post-LASIK ectasia.
Main Methods:
- Review of papers published within the past year on ectasia after LASIK.
- Expert panel summary of current knowledge and risk mitigation strategies.
- Analysis of case reports on pathogenesis and treatment options.
Main Results:
- Ectasia can occur even without identifiable risk factors, suggesting undetected biomechanical vulnerabilities.
- Limitations in current diagnostic tools, such as Orbscan, regarding accuracy and reproducibility of posterior corneal data are noted.
- A biomechanical model suggests unique corneal responses to LASIK.
- Case reports offer insights into histopathology, pseudokeratectasia, and ectasia related to intraocular pressure, prior surgery, and devices like intracorneal rings.
Conclusions:
- Knowledge regarding corneal ectasia is still developing.
- Further understanding of corneal biomechanics and genetics may help reduce ectasia incidence.
