Topoguided laser as treatment of ectasia after lasik

ABSTRACT The laser in situ keratomileusis (LASIK) is the most widely used refractory surgical method in the world with excellent results, but this method is not without risks. Post-LASIK ectasia is a serious complication and is characterized by a progressive increase in curvature and thinning of the cornea, resulting in irregular astigmatism and decreasing visual acuity. Its incidence in the current literature is approximately 0.033%. The main treatment for this complication is the implantation of an intra-stromal ring with crosslinking. In this article, we describe a case of a 45-year-old woman who underwent successive attempts to treat post-LASIK ectasia, with bilateral intra-stromal ring implantation, with no success in the eyes. Excimer laser was used, made through photorefractive keratectomy (PRK) without cross-linking and the patient obtained significant improvement in vision and in quality of life.

摘要
准分子激光原位角膜磨镶术（Laser in situ keratomileusis，LASIK）是全球应用最为广泛的屈光手术，临床疗效优异，但该术式并非毫无风险。LASIK术后角膜扩张症是其严重并发症之一，以角膜曲率进行性升高、角膜基质厚度进行性变薄为特征，进而引发不规则散光与视力下降。现有文献报道其发病率约为0.033%。该并发症的主流治疗方案为植入角膜基质内环（intra-stromal ring）联合交联术（crosslinking）。本文报告1例45岁女性患者，该患者曾先后接受LASIK术后角膜扩张症治疗，包括双侧角膜基质内环植入术，但双眼均未获得理想疗效。随后采用准分子激光行光屈光性角膜切削术（photorefractive keratectomy，PRK），未联合交联术，患者术后视力与生活质量均获得显著改善。