Pregnancy-triggered iatrogenic (post-laser in situ keratomileusis) corneal ectasia--a case report

Abstract

Purpose: To report a patient who developed bilateral corneal ectasia, during pregnancy, one and a half years after laser in situ keratomileusis for correction of myopia.

Method: Case report with relevant literature review.

Results: A 20-year-old woman, with a stable myopic astigmatism underwent laser in situ keratomileusis for the correction of her refractive error. Preoperative clinical examination and topographic automated keratoconus screening did not suggest keratoconus in either eye. The patient had a preoperative corneal thickness of 527 and 525 microm, and a postoperative residual bed thickness of 305 and 282 microm in the right and left eyes, respectively. After being fully satisfied with the outcome of the procedure, she reported 18 months later, in the first trimester of pregnancy, with signs and symptoms of corneal ectasia, which steadily worsened with advancing pregnancy.

Conclusion: Pregnancy could prompt hormonal changes, which in turn could affect the biomechanical stability of the cornea, leading to corneal ectasia.