To provide a comprehensive overview of ectasia development following laser-assisted in situ keratomileusis (LASIK).
Materials and methods
Literature review of relevant studies dealing with corneal ectasia associated with refractive surgery, keratoconus (KC), and cross-linking.
Post Laser-assisted (PLE) involves histopathologic, clinical, and topographic characteristics similar to KC. Several risk screening indices were developed to enhance the detection of KC suspect and mild KC cases prior to the laser procedure. A grading system of PLE was developed, based on risk factors for the severity of ectasia, primarily measured by visual loss. The aims of the treatment are halting ectasia progression and restoring visual acuity.
Familiarity with the highly sensitive and specific indices for ectasia screening, in addition to procedure parameters that increase the likelihood of ectasia development following the refractive procedure, is essential for minimizing the risk of PLE. However, when ectasia develops, early recognition and proper management are essential to prevent progression and improve visual rehabilitation.
How to cite this article
Busool Y, Barbara A. Post Laser-assisted in situ Keratomileusis Ectasia: A Systematic Review. Int J Kerat Ect Cor Dis 2017;6(2):78-86
Corneal ectasia after PRK. Int J Kerat Ect Cor Dis 2012 Jan-Apr;1(1):73-74.
Corneal ectasia after excimer laser keratorefractive surgery: histopathology, ultrastructure, and pathophysiology. Ophthalmo-logy 2008 Dec;115(12):2181.e1-2191.e1.
Collagen corneal cross-linking followed by Intacs implantation in a case of post-PRK ectasia. Int J Kerat Ect Cor Dis 2012 Jan-Apr;1(1):68-72.
Risk factors and prognosis for corneal ectasia after LASIK. Ophthalmology 2003 Feb;110(2):267-275.
Risk profiles of ectasia after keratorefractive surgery. Curr Opin Ophthalmol 2017 Jul;28(4):337-342.
Ectasia risk factors in refractive surgery. Clin Ophthalmol 2016 Apr;10:713-720.
Evaluation of the percentage tissue altered as a risk factor for developing post-laser in situ keratomileusis ectasia. J Cataract Refract Surg 2017 Jul;43(7):946-951.
Iatrogenic keratectasia after laser in situ keratomileusis. J Refract Surg 1998 May-Jun;14(3):312-317.
Keratoconus and related noninflammatory corneal thinning disorders. Surv Ophthalmol 1984 Jan-Feb;28(4):293-322.
Computer-assisted corneal topography in family members of patients with keratoconus. Arch Ophthalmol 1990 Mar;108(3):365-371.
Post-LASIK keratoectasia developing with sleep apnea and floppy eyelid syndrome: case report and review of the literature. Int J Kerat Ect Cor Dis 2014 Jan-Apr;3(1):44-46.
Topographic and tomographic indices for detecting keratoconus and subclinical keratoconus: a systematic review. Int J Kerat Ect Cor Dis 2013 May-Aug;2(2):60-64.
KISA% index: a quantitative video keratography algorithm embodying minimal topographic criteria for diagnosing keratoconus. J Cataract Refract Surg 1999 Oct;25(10):1327-1335.
Comparison of methods for detecting keratoconus using videokeratography. Arch Ophthalmol 1995 Jul;113(7):870-874.
Vertical D: a novel topographic pattern in some keratoconus suspects. Ophthalmology 2007 May;114(5):1020-1026.
Comparison of and correlation between anterior and posterior corneal elevation maps in normal eyes and keratoconus-suspect eyes. J Cataract Refract Surg 2008 May;34(5):789-795.
Corneal volume, pachymetry, and correlation of anterior and posterior corneal shape in subclinical and different stages of clinical keratoconus. J Cataract Refract Surg 2010 May;36(5):814-825.
Comparative evaluation of elevation, keratometric, pachymetric and wavefront parameters in normal eyes, subclinical keratoconus and keratoconus with a dual Scheimpflug analyzer. Int J Kerat Ect Cor Dis 2012 Sep-Dec;1(3):158-166.
Risk assessment for ectasia after corneal refractive surgery. Ophthalmology 2008 Jan;115(1):37-50.
Enhanced screening for ectasia risk prior to laser vision correction. Int J Kerat Ect Cor Dis 2017 Jan-Jun;6(1):23-33.
In vivo confocal microscopy and tear cytokine analysis in post-LASIK ectasia. Br J Ophthalmol 2017 Apr:pii:bjophthalmol-2016-309142.
One-Year Follow-up of Corneal Confocal Microscopy After Corneal Cross-Linking in Patients With Post Laser In Situ Keratosmileusis Ectasia and Keratoconus. Am J Ophthalmol 2009;147(5):774-778.
Risk factors and prognosis for corneal ectasia after LASIK. Ophthalmology 2003;110(2):267-275.
Various topographic patterns of post-LASIK ectasia and their treatment modalities. Delta J Ophthalmol 2016 Dec;17(3):114-122.
Topographic, tomographic, and aberrometric characteristics of post-LASIK ectasia. Optom Vis Sci 2016 Nov;93(11):1364-1370.
Characteristics of corneal ectasia after LASIK for myopia. Cornea 2004 Jul;23(5):447-457.