Unilateral Traumatic Posterior Corneal Ectasia: Clinical Manifestations, Findings of Advanced Imaging, and Long-term Follow-up

Abstract

PURPOSE: To describe a case of unilateral isolated traumatic posterior corneal ectasia characterized by advanced multi-modal diagnostic tests. METHODS: Case report and literature review. RESULTS: Following blunt trauma to the left eye, a 34-year-old woman presented with persistently blurry vision. Central corneal thickness was 300 µm, compared to 519 µm in the right eye. Scheimpflug tomography revealed significant corneal thinning in a defined inferotemporal region with corresponding elevation of the posterior corneal surface. Posterior corneal ectasia was confirmed with anterior segment optical coherence tomography. Wavefront aberrometry demonstrated increased higher order aberrations in the affected eye. Vision remained stable during 4.5 years of follow-up with a final visual acuity of 20/50 maintained with spectacle correction only. CONCLUSIONS: A unique case of unilateral post-traumatic posterior corneal ectasia was presented. The multi-modal imaging provided a detailed characterization of the structural characteristics of the cornea, guided management, and allowed for differentiation from other corneal pathologies at an early stage. [ Journal of Refractive Surgery Case Reports . 2021;1(2):e31–e35.]