Corneal Ectasia After LASIK Combined With Prophylactic Corneal Cross-linking

PURPOSE: To report a case of unilateral corneal ectasia following LASIK surgery combined with prophylactic corneal cross-linking (CXL) in a young patient. METHODS: Case report. RESULTS: Preoperative topography was unremarkable in both eyes with a minimum corneal thickness of 554 μ m in the right eye and 546 μ m in the left eye. Preoperative corrected distance visual acuity (CDVA) was 1.0 (20/20 Snellen) in both eyes with a refraction of +1.25 −2.75 × 10 in the right eye and +0.50 −2.00 × 163 in the left eye. LASIK combined with CXL was uneventful. After 12 months, postoperative topography was unremarkable with an uncorrected distance visual acuity (UDVA) of 1.0 in both eyes. Two years after surgery, the patient presented with a loss of vision (UDVA 0.25) and an inferior steepening on topography in the left eye. Standard CXL was performed to arrest further progression. CONCLUSIONS: This report illustrates that the currently used prophylactic CXL protocol in combination with LASIK may not be effectively preventing corneal ectasia in every case. [ J Refract Surg. 2017;33(1):50–52.]