title: Post-LASIK keratectasia triggered by eye rubbing and treated with topography-guided ablation and collagen cross-linking--a case report.
abstract: OBJECTIVE
  To report a case of unilateral post-laser-assisted in situ keratomileusis (LASIK) keratectasia in a 35-year-old woman who had no known predisposing risk factors but who rubbed her affected eye frequently and vigorously in response to allergic conjunctivitis.
  
  
  METHODS
  Case report with relevant literature review.
  
  
  RESULTS
  A 35-year-old woman, with a cumulative risk scale score of 0 (according to the Randleman criteria), who underwent bilateral LASIK developed unilateral post-LASIK keratectasia 32 months later. She presented with a history of vigorous eye rubbing of the affected eye since about a year after allergic conjunctivitis. The fellow eye, which was not rubbed, remained normal. She complained of glare, halos, and ghost images in her affected eye. She underwent transepithelial topography-guided customized ablation with simultaneous UV-A corneal collagen cross-linking, after which she improved symptomatically and topographically.
  
  
  CONCLUSIONS
  Eye rubbing could contribute to the development of keratectasia, even in an eye that has no subclinical features of the disease. When detected early, a simultaneous combined topography-guided customized ablation treatment and collagen cross-linking is effective in improving the irregular corneal contour and restoring biomechanical stability.
authors.affiliation: Department of Cornea & Refractive Surgery, Medical & Vision Research Foundation, Sankara Nethralaya, Chennai, India. drpp@snmail.org
authors.forename: Prema
authors.initials: P
authors.lastname: Padmanabhan
authors.forename: R
authors.initials: R
authors.lastname: Aiswaryah
authors.forename: V
authors.initials: V
authors.lastname: Abinaya Priya
mesh_terms: D000328:Adult; D003094:Collagen / Q000378:metabolism; D003131:Combined Modality Therapy; D003316:Corneal Diseases / Q000209:etiology* / Q000378:metabolism / Q000628:therapy*; D003319:Corneal Stroma / Q000378:metabolism; D019781:Corneal Topography; D003432:Cross-Linking Reagents / Q000627:therapeutic use*; D004108:Dilatation, Pathologic / Q000209:etiology / Q000378:metabolism / Q000628:therapy; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D053685:Laser Therapy; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008405:Massage / Q000009:adverse effects*; D017319:Photosensitizing Agents / Q000627:therapeutic use; D011183:Postoperative Complications; D012256:Riboflavin / Q000627:therapeutic use; D014466:Ultraviolet Rays
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin