Over the last decade there has been a paradigm shift from penetrating keratoplasty (PKP) to lamellar keratoplasty for the management of primary as well as acquired corneal ectasia. Several treatment modalities have emerged including collagen cross-linking, intrastromal implants, laser vision correction, and recent techniques in central and peripheral lamellar keratoplasty. This article reviews ...

The mechanisms underlying the success of UVA–riboflavin collagen cross-linking (CXL) to arrest or allay corneal ectasia are not well understood. One observation that may shed light on the underpinnings of CXL: the cornea thins after the procedure for at least several months. Thinning produces a more compact and stiffer tissue. Normally, corneal thickness is controlled by endothelial active tran...

PURPOSE To determine preoperative patient characteristics that may predict topography and visual acuity outcomes of corneal collagen crosslinking (CXL). SETTING Cornea and refractive surgery practice. DESIGN Cohort study. METHODS Crosslinking was performed in eyes with keratoconus or corneal ectasia. Multiple regression and odds ratio analyses were performed to determine independent predi...

PURPOSE To evaluate and compare visual, refractive, and corneal aberrometric outcomes after implantation of 2 types of intrastromal corneal ring segments (ICRS) in eyes with early to moderate ectatic disease. SETTINGS Vissum Corporation-Instituto Oftalmológico de Alicante, Alicante, Spain. METHODS This retrospective analysis comprised consecutive eyes with grade I or grade II corneal ectasi...

Purpose. To evaluate the risk factors for post-laser in situ keratomileusis (LASIK) ectasia. Materials and Methods. Medical records of 42 eyes of 28 (10 women, 18 men) patients who developed corneal ectasia after LASIK were retrospectively reviewed. Topographical features and surgical parameters of those patients were evaluated. Results. The mean age of patients was 34.73 ± 6.50 (23-48) years a...

PURPOSE To evaluate the refractive and aberrometric changes in corneas with post-LASIK keratectasia implanted with intracorneal ring segments (ICRS) during a 2-year follow-up. DESIGN Retrospective, consecutive case series. PARTICIPANTS Thirty-four eyes of 25 patients (age range, 20-59 years) with post-LASIK ectasia were included. Ectasia was diagnosed by slit-lamp appearance of corneal thin...

PURPOSE To evaluate 1-year outcomes of corneal collagen crosslinking (CXL) for treatment of keratoconus and corneal ectasia. SETTING Cornea and refractive surgery subspecialty practice. DESIGN Prospective randomized controlled clinical trial. METHODS Collagen crosslinking was performed in eyes with keratoconus or ectasia. The treatment group received standard CXL and the sham control grou...

PURPOSE To determine the natural history of collagen crosslinking (CXL)-associated corneal haze measured by Scheimpflug imagery and slitlamp biomicroscopy in patients with keratoconus or ectasia after laser in situ keratomileusis. SETTING Cornea and refractive surgery subpecialty practice, United States. DESIGN Prospective randomized controlled clinical trial. METHODS The treatment group ...

Objective: LASIK is associated with a severe complication known as corneal ectasia. A direct evaluation of the biomechanical corneal property may be performed to select patients for excimer laser surgery. Methods: Detection of the biomechanical corneal properties was performed using a specific device known to produce short intraocular pressure elevation (IOP) at approximately 20 mm Hg. The corn...

PURPOSE To evaluate the safety and efficacy of intrastromal corneal ring segments (ICRS, INTACS, Keravision) for the correction of corneal ectasia after laser in situ keratomileusis (LASIK). METHODS In this prospective, noncomparative case series, INTACS were implanted in three eyes (two patients) that were ectatic after LASIK. Mean follow-up was 8.7 months (range, 8 to 10 mo). RESULTS No i...