Abstract
Purpose. To demonstrate keratoconus-like hydrops after laser in situ keratomileusis (LASIK) by optical coherence tomography (OCT). Patient and Methods. A 21-year-old man received uneventful bilateral LASIK. On slit lamp examination or corneal topography there were no signs of fruste keratoconus. The preoperative corneal thickness was 587-μm OD and the calculated ablation for two treatments was 114-μm. Uneventful LASIK with an optical zone of 7 mm and an ablation of 89-μm OD, and an ablation of 73-μm OS was performed. Three years postoperatively, he complained about progressive myopia and impaired vision OD. His VA was hand motion OD and 20/20 OS. Results. OCT and light microscopy revealed an anterior corneal steepening and acute keratoconus-like excessive edematous swelling. Conclusion. The cornea is mechanically weakened after LASIK by the lamellar cut and tissue subtraction. Although the advocated minimal residual stromal bed thickness is 250-μm, it may not be adequate to prevent progressive keratoconus-like hydrops in the selected cases.
Highlights
After laser in situ keratomileusis (LASIK) the integrity of the posterior stromal bed is excessively compromised by the disruption of corneal lamellae that occurs when the microceratom passes through the stroma and a consecutive excimer laser photoablation is performed [1]
There is concern that, at some point, the tensile strength of the cornea might be reduced to the degree that progressive ectasia ensues, resulting in corneal steepening, progressive myopia and irregular astigmatism
We present the tomographic features of a patient who developed progressive corneal hydrops after LASIK after a moderate ablation below 120-μm
Summary
Acute keratoconus-like corneal swelling is associated with anterior corneal steepening. There is concern that, at some point, the tensile strength of the cornea might be reduced to the degree that progressive ectasia ensues, resulting in corneal steepening, progressive myopia and irregular astigmatism. It has been stated that a residual stromal thickness of at least 250-μm is necessary to forestall iatrogenic keratectasia after LASIK [2]. We present the tomographic features of a patient who developed progressive corneal hydrops after LASIK after a moderate ablation below 120-μm.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
