[Iatrogenic Keratectasia: A Review]

Area of Science:

• Ophthalmology
• Corneal Surgery
• Refractive Surgery

Context:

• Iatrogenic corneal ectasia is a rare but serious complication following corneal laser surgery.
• It can manifest weeks to years after procedures like LASIK, PRK, and other refractive surgeries.
• Reported incidence rates vary, ranging from 0.04% to 2.8%.

Purpose:

• To review the characteristics, risk factors, and management of iatrogenic corneal ectasia.
• To highlight the progressive nature of the condition and its impact on visual acuity.
• To discuss current treatment options, including corneal cross-linking and surgical interventions.

Summary:

• Corneal ectasia presents with progressive myopia, irregular astigmatism, and significant visual disturbances.
• Key risk factors include thin corneas (<500 µm), shallow residual stromal bed (<300 µm), high myopia (>8 D), young age (<25 years), and a history of allergies or keratoconus.
• Treatment involves corneal cross-linking with riboflavin/UVA light; severe cases may require corneal transplantation.

Impact:

• Understanding risk factors and early signs of corneal ectasia is vital for patient safety in refractive surgery.
• Prompt diagnosis and treatment, such as corneal cross-linking, can halt disease progression and preserve vision.
• This review provides essential information for ophthalmologists managing patients at risk for or presenting with post-refractive surgery ectasia.