Pregnancy-related exacerbation of iatrogenic keratectasia despite corneal collagen crosslinking.
Iatrogenic keratectasia after laser in situ keratomileusis (LASIK) represents a serious complication of refractive laser surgery. We describe a woman who developed bilateral iatrogenic keratectasia during her first pregnancy 26 months after LASIK. Corneal collagen crosslinking (CCL) with riboflavin and ultraviolet-A was performed in March 2005 (right eye) and April 2005 (left eye). This treatment stopped the progression and even caused the keratometric steepness to regress over a postoperative follow-up of 22 months, as demonstrated by preoperative and postoperative corneal topographies and maximum K-readings. During the patient's second pregnancy, the keratectasia exacerbated. To our knowledge, this is the first case showing exacerbation of keratectasia despite CCL and, as the exacerbation occurred only during pregnancy, suggesting that hormonal changes might affect corneal biomechanical stability.
Institute for Refractive and Ophthalmic Surgery, Zurich, Switzerland. farhad.hafezi@iroc.ch
Farhad
F
Hafezi
Hans Peter
HP
Iseli
D000328:Adult; D003094:Collagen / Q000378:metabolism* / Q000528:radiation effects; D003315:Cornea / Q000378:metabolism / Q000473:pathology*; D003316:Corneal Diseases / Q000209:etiology*; D019781:Corneal Topography; D004108:Dilatation, Pathologic / Q000209:etiology; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D020731:Keratomileusis, Laser In Situ; D054018:Lasers, Excimer / Q000627:therapeutic use; D017319:Photosensitizing Agents / Q000627:therapeutic use; D011247:Pregnancy; D011248:Pregnancy Complications; D012256:Riboflavin / Q000627:therapeutic use; D014466:Ultraviolet Rays
D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin