Iatrogenic keratoconus as a complication of radial keratotomy.
A 47-year-old man with a family history of keratoconus had uneventful bilateral radial keratotomy (RK) with astigmatic keratotomy (AK) enhancements 12 years earlier. He noticed a gradual onset of blurry vision with progressively increasing myopic shift. Visual acuity remained poor even with spectacles or soft contact lenses. Slitlamp examination revealed 16 well-healed RK scars and 2 AK scars with marked corneal steepening inferiorly in an area of astigmatic enhancement in the left eye but an otherwise normal fellow eye with 16 well-healed RK scars. He subsequently had penetrating keratoplasty for decreased vision not correctable by rigid gas-permeable contact lenses. Microscopic examination of the corneal button showed findings consistent with keratoconus. This case represents the first documented incidence of corneal ectasia as a complication of primary RK.
Shaikh
Saad
S
Stanford University School of Medicine, Stanford, California 94305, USA.
Shaikh
Naazli M
NM
Manche
Edward
E
D003315:Cornea / Q000473:pathology / Q000601:surgery; D019781:Corneal Topography; D006801:Humans; D007049:Iatrogenic Disease; D007640:Keratoconus / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D015948:Keratoplasty, Penetrating; D007646:Keratotomy, Radial / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged