Ectasia after laser in situ keratomileusis

J Cataract Refract Surg. 2003 Dec;29(12):2419-29. doi: 10.1016/j.jcrs.2003.10.012.


Eighty-five cases of post laser in situ keratomileusis ectasia were reviewed and analyzed. Cases of keratoconus or forme fruste keratoconus were eliminated; many remaining case reports lacked key information. The current literature is unable to define a specific residual corneal thickness or a range of preoperative corneal thickness that would put an eye at risk for developing ectasia. The most logical cause for eyes without preexisting pathology to develop ectasia is a postablation stromal thickness that is mechanically unstable; this "minimal" thickness is probably specific to each eye. The preoperative and postoperative corneal thickness, measured flap thickness, and microkeratome and laser parameters used in a given case are required to determine the range of residual corneal thickness that puts the eye at risk for developing ectasia. Other as yet undetermined factors may play a role in the development of this complication.

Publication types

  • Review

MeSH terms

  • Cornea / pathology*
  • Corneal Diseases / diagnosis
  • Corneal Diseases / etiology*
  • Dilatation, Pathologic / etiology
  • Female
  • Humans
  • Keratomileusis, Laser In Situ / adverse effects*
  • Male
  • Risk Factors
  • Surgical Flaps / pathology