Myopic LASIK and LASEK in patients with preoperative mean central keratometry ≥47.50 D

To evaluate whether patients who undergo myopic LASIK or laser epithelial keratomileusis (LASEK) with preoperative central keratometry ≥47.50 diopters (D) are at higher risk for developing corneal ectasia postoperatively.

Records of 32 patients (54 eyes) who underwent myopic LASIK or LASEK between May 2002 and July 2005 with preoperative mean central keratometry ≥47.50 D were retrospectively reviewed. Patients eligible for the study were offered free follow-up. Last follow-up was at least 3 years after surgery. All procedures were performed with the Technolas Keracor 217z excimer laser (Bausch & Lomb).

Twenty-four patients (40 eyes) had LASIK and 8 patients (14 eyes) had LASEK. At last follow-up, no patient had developed ectasia.

This study suggests that patients with preoperative central keratometry ≥47.50 D as the only parameter evaluated should not be excluded from corneal refractive surgery due to increased risk of postoperative ectasia. However, when this preoperative finding is accompanied by other topographic abnormalities, treatment options should be carefully evaluated.