High myopia, forme fruste keratoconus and thin residual stromal beds are risk factors for corneal ectasia after laser in situ keratomileusis (LASIK). JB Randleman and colleagues from Emory University, Atlanta, Georgia, United States, retrospectively analysed 10 eyes from seven patients who developed corneal ectasia after LASIK.
The authors also enrolled 33 patients who previously developed ectasia as well as two control groups: the first control group consisted of 100 patients with uneventful LASIK and normal postoperative courses, the second control group had 100 cases who showed high preoperative myopia of more than 8 dioptres (D). Follow-up after LASIK lasted an average of 23.4 months, but ranged from 6 to 48 months.
Corneal ectasia developed in a mean of 16.3 months, although this ranged from 1 to 45 months. Preoperative refraction in patients that developed post-LASIK ectasia averaged -8.69 D. This compared to -5.37 D for controls with uneventful LASIK. Before LASIK, 88% of patients that developed ectasia following LASIK showed forme fruste keratoconus. This compared to 2% of controls with uneventful LASIK and 4% of the controls with high preoperative myopia.
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