Post-LASIK Ectasia Recovery Possible Through Appropriate Disease Management

From left, Kay Coulson, Dr. Jim Montgomery and Marlene Beckett perform a CK (conductive keratoplasty) procedure on a patient at Insight Lasik in Lafayette, Colo. Montgomery is the only eye surgeon in Colorado currently certified to perform CK. (The Denver Post / Jerry Cleveland) (Photo By Jerry Cleveland/The Denver Post via Getty Images)
A retrospective case series demonstrates how most patients with post-LASIK ectasia can regain functional visual with the right management.

This article is part of Ophthalmology Advisor’s conference coverage from the 2021 meeting of American Society of Cataract and Refractive Surgery (ASCRS), held in Las Vegas from July 23 to 27, 2021. The team at Ophthalmology Advisor will be reporting on a variety of research presented by the cataract and refractive surgery experts at ASCRS. Check back for more from the ASCRS 2021 Meeting.


Most patients who experience post-LASIK ectasia can regain functional visual acuity after appropriate disease management, according to research results presented at the American Society of Cataract and Refractive Surgery (ASCRS) 2021 meeting in Las Vegas.

A researcher conducted a retrospective case series review of 10 eyes from 7 patients that developed post-LASIK ectasia. The report shows clinical outcomes after treatment. In these cases, postoperative ectasia included forme fruste keratoconus, thin cornea, posterior elevation map value >+15.0 µm, or residual stromal bed <300 µm. 

In all cases, the LASIK flap was created using the Moria M2 mechanical microkeratome, with an average flap thickness of 118.15±12.88 µm; refractive errors were corrected using an excimer laser. 

All cases were treated via either collagen crosslinking (CXL) alone, CXL combined with PRK, or CXL and phakic intraocular implant using the Dresden protocol. 

The average preoperative corrected distance visual acuity (CDVA) was 0.75±0.26 Snellen. Postoperatively, CDVA increased significantly to 0.86±0.13 Snellen (P =.04). One eye lost 3 lines of baseline CDVA before ectasia, while all other eyes regained CDVA lines. All cases were stable on follow-up. 

“Although ectasia remains a potentially devastating complication after refractive surgery, most patients can regain functional visual acuity with appropriate management,” according to the researcher. “Corneal transplantation is infrequently indicated.” 

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Gabric I. Management of post-LASIK ectasia. Paper presented at: 2021 ASCRS Annual Meeting; July 2021; Las Vegas, NV. Paper 75495.