title: Latrogenic keratectasia following laser in situ keratomileusis.
abstract: OBJECTIVE
  To evaluate keratectasia after laser in situ keratomileusis (LASIK) for high myopia.
  
  
  METHODS
  A 49-year-old male patient with myopia of -23.50 D in both eyes underwent LASIK with a Summit Technology Apex Plus excimer laser. A Moria manually-guided MDSC microkeratome was used. Preoperative corneal topography in both eyes did not reveal underlying or fruste form of keratoconus. Four months after LASIK, a progressive keratectasia occurred in right eye and after 12 months, in left eye. Corneal transplantation was performed in both eyes.
  
  
  RESULTS
  Histological and ultrastructural examinations were performed on one corneal button. The analysis showed regular stromal morphology and cellularity, with no sign of inflammation. The morphometric analysis showed an overall thickness of 334 microm, with a flap of 262 microm and a stromal residual bed of 72 microm, in the center of the button.
  
  
  CONCLUSIONS
  A LASIK corneal flap made with a planned 120-microm plate turned out histologically to be approximately 260 microm thick, in an eye with a refractive correction of -23.50 D. The excessive flap thickness and excessive ablation produced progressive keratectasia requiring a penetrating keratoplasty.
authors.affiliation: University of L'Aquila, Italy. lspadea@cc.univaq.it
authors.forename: Leopoldo
authors.initials: L
authors.lastname: Spadea
authors.forename: Giampiero
authors.initials: G
authors.lastname: Palmieri
authors.forename: Luigi
authors.initials: L
authors.lastname: Mosca
authors.forename: Romina
authors.initials: R
authors.lastname: Fasciani
authors.forename: Emilio
authors.initials: E
authors.lastname: Balestrazzi
mesh_terms: D003315:Cornea / Q000473:pathology* / Q000601:surgery; D003316:Corneal Diseases / Q000209:etiology*; D019781:Corneal Topography; D016039:Corneal Transplantation; D004108:Dilatation, Pathologic; D006801:Humans; D007049:Iatrogenic Disease; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery*; D013524:Surgical Flaps; D016896:Treatment Outcome; D014792:Visual Acuity