Posters

Post-photorefractive keratectomy corneal astigmatism induced by mechanical eye rubbing

Poster Details

First Author: K.Giannopoulou GREECE

Co Author(s):    V. Liarakos   G. Karastatiras   N. Kappos   E. Kiskira   I. Tzavella        

Abstract Details

Purpose:

To report the development of corneal astigmatism after photorefractive keratectomy (PRK) and its correlation to eye rubbing.

Setting:

(1) Naval and Veterans Hospital, Athens, Greece (2) AKTINA Center, Athens, Greece

Methods:

A 27-year-old- man underwent PRK for myopia in both eyes for refraction of -7.75 sph -0.50 cyl x 180 degrees in the right eye (OD) and -7.50 sph -0.25 cyl x 180 degrees in the left eye (OS). Pre-operative best-corrected visual acuity (BCVA) was 1.0 in both eyes (OU). Central keratometry was 41.9/42.7 diopters (D) in OD, and 41.9/42.6 D in OS. A residual stromal thickness of about 400μm was left OU. Dual Scheimpflug and Placido corneal topography, optical coherence tomography (OCT) and ray-tracing aberrometry measurements were performed during follow-up.

Results:

Uncorrected visual acuity (UCVA) reached 1.2 within one week after PRK. Topography and tomography measurements were regular and stable over the postoperative period. Six months after surgery there was a relapse of the patient’s chronic allergic conjunctivitis that led him to vigorously rubbing both eyes. One year postoperatively, the patient developed astigmatism in both eyes; 1.75D and 1.25D in OD and OS respectively. Topographic astigmatism increased to 3.11D and 1.71D respectively. High Order Aberrations increased in both eyes significantly. Tomographic corneal pachymetry measurements remained stable and no ectasia pattern was recorded. After pausing eye rubbing, all measurements remained stable.

Conclusions:

Ectasia after PRK is considered a sporadic event, rarely reported in the literature. Eye rubbing is known to contribute to the development of keratectasia, even in eyes with no subclinical features of the disease. The rubbing-ectasia association described in keratoconus may also extend to other forms of keratectasia, as the one seen after PRK.

Financial Disclosure:

None