Iatrogenic keratectasia after laser in situ keratomileusis

Abstract

Background: Lamellar refractive surgery reduces the biomechanical strength of the cornea which may lead to mechanical instability and keratectasia.

Methods: Three eyes had laser in situ keratomileusis (LASIK) for myopia from -10.00 to -13.50 D. The procedures were performed with two different wide-field excimer lasers and two different microkeratomes. The patients were followed up to 1 year after surgery.

Results: Central steep areas developed between 1 and 8 months after surgery. In contrast to conventional central steep islands, these showed rapid progression and were interpreted as keratectasia.

Conclusion: Iatrogenic keratectasia represents a complication after LASIK that may limit the range of myopia correction. Based on biomechanical considerations we recommend a residual corneal thickness of the stromal bed of at least 250 microm.