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Graefes Arch Clin Exp Ophthalmol. 2007 Jun;245(6):869-75. Epub 2006 Dec 20.

Corneal ectasia after photorefractive keratectomy.

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Ophthalmic Surgery Unit, Casa di Cura Rugani, Piazza 5 Bersaglieri 2, Siena, Italy.



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


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).


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.


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.

[Indexed for MEDLINE]

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