[Keratectasia after refractive surgery].
BACKGROUND
Refractive surgery has become more and more popular in the past years. One of the most severe complications is iatrogenic keratectasia. The purpose of this article is to review the current knowledge about iatrogenic keratectasia. METHOD. A literature research (Medline) using the key words keratectasia, complication after refractive surgery and cross-linking was carried out. Apart from this, our own data from partially unpublished studies have been used.


RESULTS
Since the first publication of keratectasia in 1998 more and more cases of keratectasia have been published. The main risk factor is a preoperative irregular topography. But also thin corneas, deep ablations, thin residual stromal beds and young patients age at the time of the laser surgery are further risk factors.


CONCLUSIONS
Although preoperative examinations before refractive surgery are becoming more and more accurate and the inclusion criteria for laser ablation have become stricter, iatrogenic keratectasia still occurs. Therefore longer follow-up visits should be performed over a longer period to diagnose keratectasia in an early stage and to provide therapy.
Klinik und Poliklinik für Augenheilkunde der TUM, Klinikum rechts der Isar, Ismaningerstrasse 22, Munich. christoph.wvm@gmail.com
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Winkler von Mohrenfels
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Salgado
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Khoramnia
D001251:Astigmatism / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D003316:Corneal Diseases / Q000175:diagnosis / Q000209:etiology*; D065306:Corneal Injuries; D019781:Corneal Topography; D003432:Cross-Linking Reagents; D005500:Follow-Up Studies; D006801:Humans; D007049:Iatrogenic Disease; D007640:Keratoconus / Q000209:etiology / Q000517:prevention & control / Q000601:surgery; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D018903:Photorefractive Keratectomy / Q000009:adverse effects*; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D019736:Prostheses and Implants; D012086:Reoperation; D012307:Risk Factors; D014792:Visual Acuity
D003432:Cross-Linking Reagents