Corneal ectasia is a progressive thinning and bulging disorder that can occur after excessive stromal weakening.
The risk is low but must be considered in both primary treatment and enhancement ¹.
Key safety principles include:
- Adequate residual stromal bed (≥300 microns) ¹
- Normal pre-operative topography ²
- Absence of forme fruste keratoconus
- Conservative tissue removal ³
Enhancement should never compromise biomechanical stability.
Large retrospective series show that careful screening dramatically reduces ectasia risk ². Most cases historically occurred in inadequately screened corneas ¹ ².
Enhancement is safe when tissue margins are respected.
Long-term planning at the first surgery preserves enhancement options later ³.
Safety margins are not optional. They are mandatory.
References
- Randleman JB, Woodward M, Lynn MJ, Stulting RD. Risk assessment for ectasia after LASIK. Ophthalmology. 2008;115(1):37-50.
- Binder PS. Analysis of ectasia after LASIK. J Cataract Refract Surg. 2007;33(9):1530-1538.
- Santhiago MR, Smadja D, Gomes BF, et al. Association between residual stromal bed and ectasia risk. J Cataract Refract Surg. 2014;40(6):918-928.
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