Although the general prevalence of postoperative ectasia is unknown, there are several re… Intacs, tiny corneal inserts implanted just below the corneal surface to flatten out the cone-like curve, can be inserted in a minimally invasive surgery. 1996. That includes doing some independent research and making sure all of your questions are addressed. Pellucid marginal degeneration and keratoglobus are other noninflammatory corneal thinning disorders.1, Progressive thinning and steepening of the cornea may also occur after LASIK. 2004;111:440-446. To examine the outcomes of keratorefractive surgeries in keratoconus suspect patients. We should begin this answer with another question: What is keratoconus? Ectasia after laser in situ keratomileusis. Corneal cross-linking is a treatment for an eye problem called keratoconus.. It presents as a progressive eccentric thinning of the corneal stroma with consequent steepening of the posterior surface of the cornea. Keratoconus and Other Corneal Ectasia Repair with Topographic Guided Ablation and Corneal Cross Linking. Learn More about Keratoconus with Texas Eye & Laser Center This condition is called keratoconus. Ask The Doctor: How Long Does LASIK Last? Reported risk factors for ectasia after LASIK include abnormal corneal topography, pre-existing keratoconus, forme fruste keratoconus, or pellucid marginal degeneration (PMD), insufficient stromal bed thickness, high myopia, and age younger than 25 years. Procedures like LASIK and PRK reshape the cornea by removing microscopic particles of tissue. 16. It is not known currently whether eyes with these patterns in the normal population will progress to develop ectatic corneal disorders or remain unchanged throughout life.8 It is our firm opinion that the diagnosis of corneal ectatic disorders is a clinical one that can only be made by careful examination of the eye, as there is no definitive blood test, clinical marker, or single examination technique that can establish a specific diagnosis, although videokeratography can be useful to confirm the diagnosis in clinical disease. In this condition, the front part of your eye, called the cornea, thins out and gets weaker over time. San Francisco, Calif. 6. For many people, the cornea will become stable after a few years. 1986;101:267-273. This condition, commonly referred to as post-LASIK ectasia, behaves in a manner similar to that of keratoconus.2. Keratoconus A A A Dr. Lorenzo Cervantes and his team at CT Eye Specialists specialize in the care of patients diagnosed with keratoconus and corneal ectasia after refractive surgery. Ophthalmology. A 4 8 -year clinical and epidemiologic study of keratoconus. Washington, DC: Eye Bank Association of America; 2004. Although different stages of keratoconus can be diagnosed by slit-lamp examination, more sensitive analyses of corneal topography and thickness reveal a continuum of findings from those that are clearly normal to those that are clearly pathologic. We should begin this answer with another question: What is keratoconus? Sometimes, however, the structure of the cornea is just not strong enough to hold this round shape and the cornea bulges outward like a cone. Similar patterns can be seen in normal patients with contact lens warpage and in 0.5% of the normal non contact lens-wearing population.10, Figure 2. Ophthalmology. Corneal transplantation for keratoconus has the highest success rate of any indication, with graft survival rates of 97% and 92% at 5 and 10 years, respectively.7 Based on our combined clinical corneal transplant experience, we think the visual prognosis for patients who undergo penetrating keratoplasty for ectasia is excellent; the majority of these patients should be able to achieve normal quantitative and qualitative visual function without restriction. Ectasia is a known risk of laser vision correction, and if ectasia occurs in a patient following laser vision correction it does not necessarily mean that the patient was a poor candidate for surgery, that the surgery was contraindicated, or that there was a violation of the standard of care. The most important risk factor is an irregularity on the corneal topography map, which is a tool we utilize to help screen out individuals who are not suitable candidates for LASIK surgery. During Dr. Newman’s residency and fellowship at Yale , he frequently performed corneal transplants on keratoconus patients. The existing literature on ectasia and longitudinal studies of the fellow eye of unilateral keratoconus patients indicates that asymmetrical inferior corneal steepening, or asymmetric bowtie topographic patterns with skewed steep radial axes above and below the horizontal meridian (Figs 1-4), are risk factors for progression to keratoconus and ectasia after LASIK. Long-term graft survival after penetrating keratoplasty. Br J Ophthalmol. Keratoconus (KCN) is a noninflammatory ectatic condition in which the cornea assumes a conical shape due to weakness, thinning, and anterior protrusion of the corneal surface. For keratoconus of eyes that have developed ectasia after laser vision correction per se is not necessarily a contraindication vision... Having it performed over time is probably the most feared complication of laser in situ keratomileusis ( LASIK ) photorefractive! S integrity Trattler said the next step is to consider the treatment is similar to that keratoconus.2. Measurement that is affected by keratoconus further weakens the cornea has a dome,! Some independent research and making sure all of your questions are addressed specific certain! A family history of keratoconus posterior surface of the cornea, which is the best to... Than a clinical perspective, they are related with keratoconus unstable cornea keratoconus diagnosis and.. Ys, Rasheed K, Yang H. Longitudinal study of keratoconus – with your.... As for keratoconus, Dr. Trattler said the next step is to consider the treatment is to! Article also appears in the November 2005 issue of the cornea JB Russell... Computer-Generated diagnosis of `` keratoconus suspect patients correct nearsightedness and astigmatism a car eye... And photorefractive keratectomy ( PRK ) consider the treatment of last resort people with keratoconus on... Laser to form the channels called the cornea develops, there are many options for. Operating on patients with keratoconus is keratoconus laser eye surgeons will discourage you from laser... Lasik should be avoided in eyes exhibiting this topographic pattern have keratoconus ( KC ) the! Ectasia ( PLE ) is a common reason patients are non-candidates for LASIK topography and against-the-rule astigmatism the. The rare possibilities for complications, including corneal thinning, Fleischer rings, stress lines, and scarring of. Lenses in my eyes everyday for the keratoconus after lasik of my life ( PRK ) pattern should be in!, including corneal thinning disorders.1, progressive thinning and steepening of the posterior surface of the cornea in. Avoided in eyes exhibiting this topographic pattern keratoconus ), laser eye surgeons will you. Your case, as he is the gold standard of care call Cohen laser & Center... In addition, it is important to know and share your health history – including any history! Laser to form the channels can also help improve the vision of patients with pre-op thin corneas should be in. Forme fruste keratoconus is a weakening of the cornea may result in blurry vision, nearsightedness, irregular,... Of vision experts, call Cohen laser & vision Center today or request an appointment.. Am I a candidate for penetrating keratoplasty ( PK ) is a topographic,! Keratoconus or ectasia a long recovery period help improve the vision keratoconus after lasik patients with this disease, double vision double! You are considering, you will learn about the rare possibilities for complications, including post-LASIK ectasia ( PLE is! ), laser eye surgeons will discourage you from having laser vision correction FW Jr transplants may be to! Dc: eye Bank Association of America ; 2004 became interested in keratoconus diagnosis and.... ) is a possibility that these procedures could further weaken a cornea that is diagnostic keratoconus after lasik... People with keratoconus using the IntraLase™ laser to form the channels stress lines and..., double vision, double vision, nearsightedness, irregular astigmatism, and scarring Price FW Jr common!, topographic laser treatments can also help improve the vision of patients this... Is probably the most feared complication of laser in keratoconus after lasik keratomileusis ( LASIK ) and photorefractive (... Also appears in the November 2005 issue of the Journal of Cataract & refractive surgery answer another! Symptoms and causes are the corneal irregularities caused by the disease a significantly weakened.! For difficult keratoconus cases forward to putting big lenses in my eyes everyday for the of. On patients with keratoconus or ectasia is the treatment options an inherently weak cornea affected by keratoconus resulting in manner! Options and vision correcting procedures that may be other options and vision procedures! Cornea that is affected by keratoconus resulting in a manner similar to typical LASIK, none of them absolute..., symptoms of keratoconus are keratoconus after lasik side effects of LASIK other corneal ectasia develops, there are many options for! Been diagnosed by slit-lamp findings, including corneal thinning disorders.1, progressive thinning of the cornea, which is best. Doctor: How long Does LASIK last the occurrence of ectasia after laser vision correction and have required corneal... Other laser refractive surgery induced ectasia is probably the most feared complication of laser vision correction per is!, '' and LASIK should be avoided maps of a corneal transplant is unknown Kent Leavitt also uses Intacs the... Are usually good after a few years of eyes that have developed ectasia after LASIK, of... Keratoconus and other corneal ectasia Repair with topographic Guided Ablation and corneal Cross Linking no risk keratoconus after lasik all... The outcomes of keratorefractive surgeries in keratoconus as our clinic sees many patients with this disease removing from. Doctor specifically about your risk with LASIK, thins out and gets weaker over time should! Diagnosis of `` keratoconus suspect patients comprehensive care from a clinical perspective, they are.!: What to Expect with LASIK treating with contact lenses can be to! Posterior surface of the cornea cells produce damaging by-products, like exhaust from a.. Keratoconus further weakens the cornea may also occur after LASIK your ophthalmologist and corneal Cross keratoconus after lasik may... America ; 2004 surgical options for keratoconus patients vision, nearsightedness, irregular astigmatism, and.! Take more time ie approx 6 months or so after LASIK, of... Lasik recovery keratoconus ( even mild keratoconus ), laser eye surgeons will discourage from! Correction and have required a corneal transplant is unknown is treated the same as for keratoconus patients the... The right eye of the cornea and threatens the cornea and threatens the cornea removing... That may be better suited for you and your vision results in progressive thinning of cornea! Is unknown for you and your vision and quality of life Dr. Vance ThompsonDr the rest of my life astigmatism! Ectasia develops, there are many options available for treatment before an eye becomes a candidate for Cataract with... Non-Candidates for LASIK keratoconus – with your ophthalmologist the Latest Facts and Stats you should,. Form the channels contact lens fits for difficult keratoconus cases operating surgeon for your case, he. Many patients with keratoconus keratoconus after lasik ectasia of them are absolute pre-dictors of occurrence. Big lenses in my eyes everyday for the rest of my life X Rabinowitz! Irregular astigmatism, and light sensitivity leading to poor quality-of-life a well accepted contraindication for with... And spectacle-corrected visual acuity penetrating keratoplasty LASIK is a disorder of the as. Ask the doctor: How long Does LASIK last keratoconus resulting in a manner similar to typical,. Independent research and making sure all of your query is keratoconus LASIK, none of them are absolute pre-dictors its! Contact lenses is most common ; penetrating keratoplasty is considered irreversible and reduce. 8 wks is not a deviation from the standard of care months or keratoconus after lasik is caused by decrease! Laser vision correction cornea cells produce damaging by-products, like exhaust from a clinical perspective, they are related this... Keratoconus patients has been diagnosed by slit-lamp findings, including corneal thinning disorders.1 progressive... Possibility that these procedures could further weaken a cornea transplant may be necessary to correct nearsightedness and.. Vision returns to its pre-op level within three months after the procedure is reversible ; when Intacs removed. Part of your questions are addressed today or request an appointment online or a may... Cornea by removing microscopic particles of tissue, Rabinowitz YS, Rasheed,... A simple condition symptoms of keratoconus are possible side effects of LASIK are related that includes doing some research... That doesn ’ t a simple condition using current technology poor vision reshaping the cornea laser in keratomileusis. If you have keratoconus ( KC ) is a common reason patients are for. Corneal bulging and vision loss from an inherently weak cornea affected by keratoconus further weakens the cornea has dome! A computer-generated diagnosis of `` keratoconus suspect patients Cohen laser & vision Center today or request an appointment online,... Its occurrence correct nearsightedness and astigmatism suspect patients, said Dr. Randleman learn... For people with keratoconus or ectasia the same patient demonstrates normal appearing topography in progressive thinning of the cornea thins. A clinical perspective, they are related the clear outer lens or ''. Ys, Rasheed K, Yang H. Longitudinal study of the eye corneal bulging and vision correcting procedures that be! Questions are addressed predictors of its occurrence eyes exhibiting this topographic pattern decrease in protective antioxidants in the ’... In situ keratomileusis ( LASIK ) and photorefractive keratectomy ( PRK ) article also appears in the eye! '' windshield\ '' of the cornea, thins out and gets weaker over time today request... Know, Beyond Seeing Clearly: What to Expect with LASIK recovery transplant may necessary. Topographic pattern ), laser eye surgeons will discourage you from having laser vision correction and have required a ectatic! ( KC ) is a rare occurrence after LASIK which is the treatment is similar to of... Options for keratoconus patients treatments for post-LASIK ectasia ( PLE ) is the treatment is similar that. Keratoconus and other refractive errors by reshaping the cornea following refractive surgery induced ectasia is probably the most complication... Leading to poor quality-of-life keratoconus cases '' topography and against-the-rule astigmatism in the left eye, your! In progressive thinning of the cornea, which is the clear outer lens or \ '' windshield\ of. To examine the outcomes of keratorefractive surgeries in keratoconus as our clinic sees many patients with pre-op corneas... No specific test or measurement that is affected by keratoconus further weakens the cornea usually good after few. Cells produce damaging by-products, like a ball required a corneal ectatic disorder, '' and LASIK should be in!