Bilateral keratectasia after photorefractive keratectomy.
OBJECTIVE
To report the clinical features, management, and outcome of a patient who developed bilateral ectasia after photorefractive keratectomy (PRK).


METHODS
Case report of a 35-year-old man who underwent bilateral PRK. Preoperative uncorrected visual acuity was 20/200 in the right eye and 20/100 in the left eye. The patient's history was unremarkable and he denied a family history of ocular disorders.


RESULTS
Two weeks after surgery, the patient presented with loss of visual acuity in both eyes. Uncorrected visual acuity was 20/80 in the right eye and 20/200 in the left eye. Objective refraction could not be obtained. Slit-lamp microscopy showed corneal thinning in both eyes. After examining the patient's family, his sister was found to have clinical and topographic keratoconus.


CONCLUSIONS
Ectasia is a rare complication of PRK. We report the occurrence of bilateral ectasia after PRK in a patient with asymmetric bowtie topographies. We recommend that refractive surgery, even surface techniques such as PRK, be avoided in patients with a family history of keratoconus.
Department of Cornea and Refractive Surgery, Institute of Ophthalmology Conde de Valenciana, Mexico City, Mexico.
Alejandro
A
Navas
Enrique
E
Ariza
Alberto
A
Haber
Salomón
S
Fermón
Roberto
R
Velázquez
Raúl
R
Suárez
D000328:Adult; D000075202:Contraindications; D003315:Cornea / Q000473:pathology; D003316:Corneal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D019781:Corneal Topography; D004108:Dilatation, Pathologic / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D006801:Humans; D007640:Keratoconus / Q000235:genetics; D054018:Lasers, Excimer; D008297:Male; D018903:Photorefractive Keratectomy / Q000009:adverse effects*; D014786:Vision Disorders / Q000209:etiology / Q000503:physiopathology; D015348:Vision, Binocular; D014792:Visual Acuity