Prevention of corneal ectasia in laser in situ keratomileusis.
OBJECTIVE
Ectasia after laser in situ keratomileusis (LASIK) is a rare but serious complication. Prevention includes proper patient selection with detection of those at particular risk. Causes of ectasia include predisposition, excessive ablation with less than 250 microm of residual stromal bed, thicker than normal flap, irregular corneal thickness, and different ablation rates.


METHODS
We evaluated corneal curvature patterns and their relationship to corneal topography and pachymetry maps.


RESULTS
Corneal topography (axial, tangential, and altimetric) and pachymetry map characteristics of normally astigmatic corneas, keratoconus, false-positive and false-negative cases, as well as contact lens-induced warpage are discussed.


CONCLUSIONS
Preoperative pachymetry maps for LASIK surgery allow accurate case selection through detection of borderline cases, and provide important documentation of preoperative status, as well as useful information for improving surgical strategy. Another important parameter is the asphericity index.
Vinciguerra
P
P
Department of Ophthalmology, Istituto Clinico Humanitas, Milano, Italy. paolo.vinciguerra@humanitas.it
Camesasca
F I
FI
D003315:Cornea / Q000473:pathology; D003316:Corneal Diseases / Q000209:etiology / Q000517:prevention & control*; D019781:Corneal Topography; D004108:Dilatation, Pathologic / Q000209:etiology / Q000517:prevention & control; D005189:False Positive Reactions; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D018579:Patient Selection