Corneal Ectasia After LASIK—How to Manage

When too much central ablation is performed not respecting the safety limits, corneal ectasia can occur after laser in situ keratomileusis. This corneal ectasia is usually central and symmetric (unlike keratoconus) and does not induce irregular astigmatism. However, it can also, in some instances, assume a keratoconus-like form. It is seen usually after more than 1 year after laser in situ keratomileusis and progresses to a certain amount and then seems stable. The best-corrected visual acuity is fairly good, unlike other types of ectasia. When these characteristics are present we advise the correction of the residual myopia with a phakic intraocular lens. If irregular astigmatism develops, we suggest an intracorneal ring and, only if all this fails, the penetrating corneal graft