Corneal ectasia after PRK: clinicopathologic case report.
OBJECTIVE
To describe the clinical and ultrastructural features of a prominent ectasia of the cornea that occurred 9 years after excimer laser photorefractive keratectomy (PRK).


METHODS
Analysis of corneal topography and ultrastructural examination by transmission electron microscopy (TEM) were used to assess the ectatic cornea.


RESULTS
The intended laser ablation in the left eye was 74 microm, and the preoperative ultrasonic pachymetry was 536 microm. Orbscan II (V 3.00; Orbtek, Salt Lake City, UT) observations revealed inferior topographic steepening and protrusion of the anterior and posterior corneal surfaces 13 years after the patient underwent PRK. The least thickness of the cornea was 456 microm. TEM showed that the epithelial basement membrane had degenerated into subepithelial stroma, and apoptotic keratocytes with cell debris on the extracellular matrix were observed in the stroma. However, the endothelial cells were normal.


CONCLUSIONS
Clinical examination of an eye that had developed corneal ectasia 9 years after PRK showed forward protrusion of both anterior and posterior corneal surfaces. Ultrastructural examination also revealed a degenerated stroma. However, there was no abnormality of the corneal endothelium.
Kim
Hyojin
H
Department of Visual Optics, Division of Health Science, Baekseok University, Korea.
Choi
Jun-Sub
JS
Joo
Choun-Ki
CK
D000328:Adult; D003316:Corneal Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D019781:Corneal Topography; D004108:Dilatation, Pathologic; D005500:Follow-Up Studies; D006801:Humans; D054018:Lasers, Excimer; D008297:Male; D009216:Myopia / Q000601:surgery*; D018903:Photorefractive Keratectomy / Q000009:adverse effects*; D011183:Postoperative Complications; D013997:Time Factors; D014463:Ultrasonography; D014792:Visual Acuity