Surface ablation no guarantee for avoiding ectasia in FFKC eyes

Article

Keratoectasia can develop after surface ablation in eyes with forme fruste keratoconus (FFKC), and there do not appear to be any identifiable features as protecting against that event.

Keratoectasia can develop after surface ablation in eyes with forme fruste keratoconus (FFKC), and there do not appear to be any identifiable features as protecting against that event, said Sheraz M. Daya, MD, at Refractive Surgery Subspecialty Day.

His comments were based on a review of eight eyes of four patients seen on referral for the development of ectasia (frank ectasia, 7 eyes; FFKC progression, 1 eye) after myopic LASEK or PRK. The mean time to presentation after refractive surgery was 32 months; one case developed after 9 years, but all others occurred within 4 to 9 months. Six eyes had preoperative topographic data available and all were identified as having forme fruste keratoconus or pellucid like changes.

Preoperative corneal thickness averaged 519 µm and exceeded 500 µm in 5 of the 6 eyes. At the time of surface ablation, the patients had a mean age of 34 years and two were older than 40. Preoperative keratometry averaged 45.1 D, with a minimum K reading of 42.75/43 D, and mean preoperative SE was about -4 D.

"With the exception of the late onset case, we do not think these eyes would have developed ectasia anyway even if they did not have refractive surgery. This series also suggests a thick or flat cornea and age over 40 do not appear to reduce the risk,- said Dr Daya, director and consultant, corneoplastic unit and eye bank, Queen Victoria Hospital, West Sussex, UK, and medical director, Centre for Sight, London and East Grinstead, UK.

"Therefore, our recommendation would be to avoid surface ablation procedures in these eyes, even for low myopia, and consider other options for refractive correction," Dr. Daya concluded.

Related Videos
ARVO 2024: Andrew D. Pucker, OD, PhD on measuring meibomian gland morphology with increased accuracy
 Allen Ho, MD, presented a paper on the 12 month results of a mutation agnostic optogenetic programme for patients with severe vision loss from retinitis pigmentosa
Noel Brennan, MScOptom, PhD, a clinical research fellow at Johnson and Johnson
ARVO 2024: President-elect SriniVas Sadda, MD, speaks with David Hutton of Ophthalmology Times
Elias Kahan, MD, a clinical research fellow and incoming PGY1 resident at NYU
Neda Gioia, OD, sat down to discuss a poster from this year's ARVO meeting held in Seattle, Washington
Eric Donnenfeld, MD, a corneal, cataract and refractive surgeon at Ophthalmic Consultants of Connecticut, discusses his ARVO presentation with Ophthalmology Times
John D Sheppard, MD, MSc, FACs, speaks with David Hutton of Ophthalmology Times
Paul Kayne, PhD, on assessing melanocortin receptors in the ocular space
Osamah Saeedi, MD, MS, at ARVO 2024
© 2024 MJH Life Sciences

All rights reserved.