Corneal Ectasia After LASIK in a Patient With Normal Scheimpflug Evaluation but a High Ectasia Risk Score

PURPOSE: To present a case of ectasia after LASIK that developed in a patient with normal Scheimpflug imaging but a high Ectasia Risk Score System (ERSS) score. METHODS: Case report. RESULTS: A 24-year-old woman with no preoperative abnormalities on Scheimpflug evaluation but a cumulative ERSS risk of 4 (high risk) in the right eye and 3 (medium risk) in the left eye developed ectasia in both eyes 27 months after LASIK. She underwent ultraviolet-A corneal collagen cross-linking, with no signs of further progression. CONCLUSIONS: In this case, the ERSS was effective at predicting ectasia risk despite normal Scheimpflug imaging and only mild asymmetry on Placido topography.