Insights into a solution for post refractive surgery Ectasia

Introduction: In the recent decade, technological advancements in ophthalmology have made procedures more precise for both patients and surgeons. However, it also has detrimental side effects if used without proper research. Post-LASIK ectasia is a devastating side effect after a laser refractive procedure, where patients lose uncorrected visual acuity and experience a steepening of the cornea. This steepening causes irregular astigmatism, changeable refraction, and decreased vision with spectacles.

Case report: A 35-year-old asian female doctor visited to examine keratoconus in both eyes. The previous history showed treatment of refractive surgery in 2018, followed by redo femto LASIK in 2021. She underwent a corneal cross-linkage procedure six months before in both eyes. An ophthalmologist told her to continue traditional spectacles. The ordinary glasses were not helpful. She felt a better vision without it. Her aim of the treatment was to have a clear vision so she could perform routine tasks easily. Her condition was diagnosed as advanced keratoconus that affected her routine performance, and was successfully adjusted with a maxim scleral lens. She felt more comfortable and had better vision with a scleral lens.

Discussion: Keratoconus is a specific type of non-inflammatory corneal ectasia that gradually deteriorates vision. The condition can benefit from spectacles in mild cases, but in advanced keratoconus, glasses play a minimal role. Various contact lenses have recently become available with proper fitting, but rigid gas-permeable or the newest scleral lenses are particularly effective for correcting moderate to severe keratoconus. Adding to lens design improves compromised corneal health and comfort.

Conclusion: Post-refractive corneal ectasia affects the primary desired outcome of LASIK, excellent uncorrected distance visual acuity (udva). Ectasia after refractive surgery is characterized by a progressive increase in myopia, accompanied by or without an increase in astigmatism, and is associated with keratometric steepening of the cornea and topographic asymmetric inferior corneal steepening.