Although the general prevalence of postoperative ectasia is unknown, there are several re… Dr.’s Mathie and Lawrence perform contact lens fits for difficult keratoconus cases. Traditional laser surgeries such as LASIK are not usually recommended for keratoconus patients, but other types of structural correction may provide the desired vision correction. Normally, antioxidants get rid of them and protect the c… 3. Long-term graft survival after penetrating keratoplasty. Dr. Kent Leavitt also uses Intacs using the IntraLase™ laser to form the channels. We now recommend against performing LASIK on such patients using current technology. 4. Similar patterns can be seen in normal patients with contact lens warpage and in 0.5% of the normal non contact lens-wearing population.10, Figure 2. If you have this type, you likely won't experience severe vision problems or require further treatment.In some people with keratoconus, the cornea becomes scarred or wearing contact lenses becomes difficult. In fact, symptoms of keratoconus are possible side effects of LASIK. Randleman JB, Russell B, Ward MA, Thompson KP, Stulting RD. A condition called post-LASIK ectasia (PLE) is a rare occurrence after LASIK which is treated the same as keratoconus. Although different stages of keratoconus can be diagnosed by slit-lamp examination, more sensitive analyses of corneal topography and thickness reveal a continuum of findings from those that are clearly normal to those that are clearly pathologic. Title of your query is keratoconus but your query is about lasik. Binder PS. 2. Operating on patients with pre-op thin corneas should be avoided. “If someone has a significant cataract along with keratoconus, you have to decide how to tackle these two conditions, and there’s no required order,” he said. LASIK is a well accepted contraindication for people with keratoconus. Post LASIK Ectasia. However, removing tissue from an inherently weak cornea affected by keratoconus further weakens the cornea and threatens the cornea’s integrity. We should begin this answer with another question: What is keratoconus? The cornea cells produce damaging by-products, like exhaust from a car. J Cataract Refract Surg. Keratoconus is a naturally occurring condition that over time weakens the structural integrity of the cornea, which is the front surface of the eye. If you are diagnosed with keratoconus and told you are not a good candidate for LASIK, it is strongly recommended you take the advice of your surgeon. This is a very rare side effect that clinical research is showing to be related to mild, or subclinical (no signs or symptoms), cases of keratoconus. When you do your research, you will learn about the rare possibilities for complications, including post-LASIK ectasia. Dr. Vukich, what is post-LASIK ectasia and what is the risk? Pellucid marginal degeneration and keratoglobus are other noninflammatory corneal thinning disorders.1, Progressive thinning and steepening of the cornea may also occur after LASIK. Rather, forme fruste implies subclinical disease with the potential for progression to clinically evident keratoconus. Reported risk factors for ectasia after LASIK include abnormal corneal topography, pre-existing keratoconus, forme fruste keratoconus, or pellucid marginal degeneration (PMD), insufficient stromal bed thickness, high myopia, and age younger than 25 years. 1998;42:297-319. Keratoconus Treatment. Lance KuglerDr. These include soft contact lenses (spherical and toric), rigid gas permeable lenses (spherical, bitoric, reverse geometry), scleral contact lenses, intracorneal ring segments (INTACS; Addition Technology Ine, Des Plaines, 111),6 and lamellar keratoplasty. Figure 4. Treatments for post-LASIK ectasia are the same as for keratoconus, said Dr. Randleman. Ophthalmology. The existing literature on ectasia and longitudinal studies of the fellow eye of unilateral keratoconus patients indicates that asymmetrical inferior corneal steepening, or asymmetric bowtie topographic patterns with skewed steep radial axes above and below the horizontal meridian (Figs 1-4), are risk factors for progression to keratoconus and ectasia after LASIK. What is Cataract Surgery with Vision-Correcting IOLs? These include high myopia, reduced preoperative corneal thickness, reduced residual stromal bed after laser ablation, and asymmetrical corneal steepening (forme fruste keratoconus), but none of these characteristics definitively predict the development of ectasia.9 Ectasia can develop in eyes with no currently identifiable risk factors. Methods. 5. The most important risk factor is an irregularity on the corneal topography map, which is a tool we utilize to help screen out individuals who are not suitable candidates for LASIK surgery. It is estimated that one out of 2,000 people in the population have naturally occurring keratoconus and these are the patients at greatest risk for worsening of their corneal bulging following refractive surgery. Ask The Doctor: How Long Does LASIK Last? This study included 192 keratoconus suspects (351 eyes), treated with photorefractive keratectomy (PRK) (211 eyes), Lasik (96 eyes), and Femto-Lasik (44 eyes) surgeries in an eye clinic. Figure 3. Because keratoconus is a degenerative corneal disease that causes thinning of the cornea and leads to unpredictable and irregular changes in the shape of the front surface of the eye, LASIK … Visit lasikmd.com and learn what its symptoms and causes are. (Reproduced with permission from Rabinowitz et al. 8. Corneal transplants may be needed to replace a significantly weakened cornea. The procedure is reversible; when Intacs are removed, vision returns to its pre-op level within three months after the procedure. Dr. Vance ThompsonDr. Am I a Candidate for Cataract Surgery with Vision-Correcting IOLs? Was there any amount of keratoconus. Roholt Vision Institute specializes in treatment of keratoconus. Treatment for keratoconus depends on the severity of your condition and how quickly the condition is progressing.Mild to moderate keratoconus can be treated with eyeglasses or contact lenses. 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