Surgeons Can Use Corneal Collagen Crosslinking to Manage Post-LASIK Ectasia

Laser Eye Surgery
While corneal thinning was noted, researchers report stability or improvement in topographic parameters and acuity.

Surgeons can effectively apply corneal crosslinking (CXL) to treat ectasia following laser-assisted in situ keratomileusis (LASIK), according to a report published in Clinical Ophthalmology.

Investigators conducted a retrospective case series of patients who had progressive post-LASIK ectasia to assess the topographic and visual outcomes of CXL for treatment of the complication.

The study included 21 eyes of 11 patients (mean age, 31.3 years; 72.7% women). All patients had epithelium-off CXL and at least 2 years of follow up, with documented topographical and visual changes. At baseline, patients had a mean logMAR corrected distance visual acuity (CDVA) of 0.22±0.2 and mean spherical equivalent (SE) of -2.0±1.8 D. Mean baseline keratometry measurements included a Kmean of 42.2±3.3 D, Kmax of 48.6±4.6 D, and central corneal thickness (CCT) of 457.6±48.4 µm.

At month 24, the researchers found that the final logMAR CDVA and SE were stable compared with baseline (0.16±0.22 D, and -2.0±2.7 D, respectively). They also found that 81% of patients had stability or improvement in CDVA, SE, and Kmax. The final overall Kmean and Kmax values were 42.5 and 47.4 D, respectively. The team observed significant corneal thinning (438 vs 457 microns, P = .003), with thinning by 2% or more in 12 eyes (57.1%). 

The only ocular complication observed was failure of CXL in 4 eyes (19%). 

“Our study shows that CXL is a safe and effective interventional modality for post-LASIK ectasia. It halts the ectatic pathology, reduces corneal topographic indices, and improves visual acuity,” researchers explain.

The primary limitations of the study were the retrospective design, lack of a control group, and relatively small sample size.


Nasef MH, El Emam SY, Haleem TI, Shalaby WS, Allam WA. Visual and topographic outcomes of corneal collagen cross linking for post LASIK ectasia. Clin Ophthalmol. 2022;16:2025-2032. doi:10.2147/OPTH.S370033