Posters

Corneal ectasia after LASIK combined with corneal cross-linking

Poster Details

First Author: S. Taneri GERMANY

Co Author(s):    S. Oehler   B. Dick                 

Abstract Details

Purpose:

To report the first case of unilateral corneal ectasia following LASIK combined with prophylactic corneal crosslinking (CXL).

Setting:

Center for Refractive Surgery, Eye Department at St. Francis Hospital, Muenster, Germany

Methods:

Case report of 18-year old male patient seeking laser vision correction in 2013. Preoperative refraction was sph +1.25 cyl -2.75 Axis 10° and sph +0.50 cyl -2.00 Axis 163° in OD and OS, respectively. Corrected distance visual acuity (CDVA) was 1.0 in both eyes. Minimal corneal thickness was 554µm and 546µm in OD and OS, respectively. Preoperative topography was unremarkable in both eyes. LASIK with 120µm flap combined with CXL was uneventful. Intraoperative CXL performed with Vibex Xtra (Avedro Inc, Waltham, MA, USA) with 1:30min soak time, 1:30min illumination time with 30mW/cm2 using KXL lightsource (Avedro Inc).

Results:

One year after surgery topography was unremarkable. Uncorrected distance visual acuity (UDVA) was 1.0 in both eyes. At two years patient presented with loss of vision in OS. UDVA was 1.25 and 0.25 in OD and OS, respectively. Subjective refraction was sph 0.0 cyl -0.25 Axis 71°and sph +1.50 cyl -2.00 Axis 58° in OD and OS, respectively. CDVA was 1.25 and 0.8 in OD and OS, respectively. Topography was normal in OD, but showed inferior steepening in OS in anterior keratometry map. CXL in a therapeutic dose (3x higher than in combination with LASIK) was performed to arrest keratectasia.

Conclusions:

The addition of corneal crosslinking (with 1/3 of the established therapeutic energy dose) to LASIK may not prevent the development of corneal thinning and protrusion in eyes prone to ectatic disease. Further improvements are desirable.

Financial Disclosure:

NONE