Article

Risk factors for corneal ectasia after LASIK identified

Surgeons are better able to identify patients at high risk for developing corneal ectasia after LASIK with the help of a stratified risk factor scale, according to J. Bradley Randleman, MD.

Surgeons are better able to identify patients at high risk for developing corneal ectasia after LASIK with the help of a stratified risk factor scale, according to J. Bradley Randleman, MD.

Dr. Randleman and his co-authors Maria Woodward, MD, and R. Doyle Stulting, MD, from Emory University, Atlanta, undertook a retrospective review of 27 ectasia cases that occurred after LASIK from 1997 to 2005 and compared them with 50 consecutive controls who did not develop ectasia after LASIK. They examined patient age, gender, spherical equivalent refraction, pachymetry, predicted residual stromal bed, and topographic patterns.

They found in the ectasia cases abnormal topography patterns preoperatively, significantly lower preoperative corneal thickness and residual stromal bed (

Topographic patterns were assessed and corneas were characterized as normal (symmetrical), suspicious (presenting as asymmetric bowtie or inferior steepening or skewed radial axis), or abnormal (keratoconus).

A risk score model was developed with five risk factors: topographic abnormalities, extreme myopia, low residual stromal bed, patient age, and preoperative corneal thickness. If patients scored 4 or more on the risk score model, then the surgeon should not perform LASIK, Dr. Randleman said.

Dr. Randleman was honored with the award for best paper for the session on keratorefractive ectasia and corneal instability during the American Society of Cataract and Refractive Surgery annual meeting.

Newsletter

Don’t miss out—get Ophthalmology Times updates on the latest clinical advancements and expert interviews, straight to your inbox.

Related Videos
(Image credit: Ophthalmology Times) NeuroOp Guru: Using OCT to forecast outcomes in ethambutol optic neuropathy
(Image credit: Ophthalmology Times) Inside NYEE’s new refractive solutions center with Kira Manusis, MD
(Image credit: Ophthalmology Times) Dilsher Dhoot, MD, on the evolution of geographic atrophy therapy: where are we now?
(Image credit: Ophthalmology Times Europe) Anat Loewenstein, MD, shares insights on the real-world results of remote retinal imaging
(Image credit: Ophthalmology Times) Two-wavelength autofluorescence for macular xanthophyll carotenoids with Christine Curcio, PhD
(Image credit: Ophthalmology Times) FLIO and the brain: Making the invisible visible with Robert Sergott, MD
(Image credit: Ophthalmology Times) Structure-function correlates using high-res OCT images with Karl Csaky, MD, PhD
(Image credit: Ophthalmology Times) SriniVas Sadda, MD, on high-res OCT of atrophic and precursor lesions in AMD
(Image credit: Ophthalmology Times) Christine Curcio, PhD, shares histology update supporting review software and revised nomenclature for <3 μm OCT
© 2025 MJH Life Sciences

All rights reserved.