Corneal ectasia after photorefractive keratectomy

Graefes Arch Clin Exp Ophthalmol. 2007 Jun;245(6):869-75. doi: 10.1007/s00417-006-0507-z. Epub 2006 Dec 20.


Background: Corneal ectasia after photorefractive keratectomy (PRK) has only been occasionally reported, and its incidence has not been assessed.

Methods: In a retrospective, non-comparative case series, incidence of corneal ectasia was evaluated in a personal consecutive 6453-case series of myopic PRK with a minimum follow-up of 18 months. Features and prognosis were evaluated in all patients with ectasia after PRK (in both personal and referred cases).

Results: Ectasia was detected in three eyes of two patients (patients 1 and 2) 3 years and 1 year after PRK performed elsewhere. In addition, in the personal PRK series, two eyes of two patients (patients 3 and 4) developed corneal ectasia 5 months after surgery (incidence: 0.03%). Pre-operatively, forme fruste keratoconus was present in patients 1, 3 and 4; keratoconus in the fellow eye in patient 2; pachymetry <500 micron in patients 2 and 3. In patient 1, rigid contact lenses were prescribed, and in patient 2 deep anterior lamellar keratoplasty was needed; in patients 3 and 4, low induced astigmatism resulted, requiring driving spectacles in patient 3.

Conclusions: PRK induced corneal ectasia in predisposed eyes, even after low myopic ablations. Forme fruste keratoconus and keratoconus in the fellow eye were the main pre-operative findings. Prognosis varies according to severity.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Contact Lenses
  • Cornea / pathology*
  • Corneal Diseases / diagnosis
  • Corneal Diseases / etiology*
  • Corneal Diseases / therapy
  • Corneal Topography
  • Corneal Transplantation
  • Dilatation, Pathologic / diagnosis
  • Dilatation, Pathologic / etiology
  • Eyeglasses
  • Female
  • Humans
  • Incidence
  • Keratoconus / diagnosis
  • Lasers, Excimer
  • Male
  • Myopia / surgery*
  • Photorefractive Keratectomy*
  • Postoperative Complications*
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Visual Acuity