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Unilateral ectasia after LASIK in a patient with abnormal topography but normal tomography
Emmanuel Guilbert1, Alain Saad, Damien Gatinel
1Department of Cataract and Refractive Surgery, Rothschild Foundation and the Center for Expertise and Research in Optics for Clinicains, Paris, France. emmanuel.guilbert83@gmail.com
Purpose:
To report a case of unilateral ectasia developing after LASIK in a patient with abnormal topography but normal tomographic indices.
Methods:
Case report and literature review.
Results:
A patient was treated bilaterally for myopia using LASIK. Five years and 5 months postoperatively, unilateral ectasia in the right eye was diagnosed. Preoperatively, anterior curvature (Placido) map of the right cornea showed an asymmetry with 1.8 diopters of steepening when evaluated from upper left to lower right meridians, and a skewing of the steepest radial axes. The calculated KISA% index was 128.4 in the right eye and 5.6 in the left eye. Conversely, posterior elevation map and pachymetry map of the right eye showed no frank abnormalities.
Conclusions:
This case is interesting because it shows that for this patient, the anterior curvature (Placido) map was more sensitive to detect cornea at risk of post-LASIK ectasia than the tomographic features
