Post lasik ectasia

Post lasik ectasia is a bulging of cornea in eyes that have undergone lasik eye surgery. The good vision obtained after laser vision correction is decreased.

Symptoms of Post lasik ectasia

After good lasik eye surgery an average person sees 20/20 or better. they are thrilled with their new vision. If the vision gradually starts decreasing requiring glasses once again – ectasia should be suspected.

Symptoms of post lasik ectasia include blurry vision and not seeing anything clearly. Increasing glare and haloes affecting night vision especially driving can be a huge problem. Rubbing of eye can be an important symptom which deteriorates the vision.

How is Post lasik ectasia detected?

An accomplished Keratoconus doctor starts by obtaining history. Family history of keratoconus, frequent rubbing of eye are red flags. Medical records showing amount of laser treatment applied and the state of prelasik cornea are helpful.

The definitive diagnosis is made by reading the topography as shown in the picture below. Pachymetry map showing thinning is also very helpful.

Post lasik ectasia treatment with cornea cross linking

Corneal cross linking was originally described for keratoconus eye disorder. It has proved useful for treating corneal bulge discovered after lasik procedure. Currently epi off cxl gives best results. FDA has approved Avedro’s Photrexa/KXL system to treat post lasik ectasia. In 2017 the only method approved is the epi off classic Dresden protocol. The epithelium over the lasik flap is carefully removed with chemicals, without disturbing the flap. The eye is than soaked with vitamin B2. Irradiation with UVA strengthens the cornea, preventing cornea from bulging forwards. In some cases it can even reverse the bulge.

Dr. Khanna is skilled in treating patients who have had prior lasik eye surgery. He performs Avedro cxl on patients needing it. His office will also help get insurance to cover it. If you have no medical insurance or the medical insurance denies cross linking, his office can offer you $0 down low affordable monthly payments.

Intacs to help vision after post lasik ectasia

Intacs intervention with laser placement can improve vision. It lifts up the bulging part of the cornea. the intacs have to be placed deep below the corneal flap.


Prevention of Post Lasik ectasia

History: Frequent rubbing of eyes. Itching or allergies

Family History: History of keratoocnus, corneal transplant

Corneal Topography: KISA index needs to be analyzed

Pachymetry distribution map: Look for focal thinning

Serial repetition o f the diagnostic tests are helpful.When in doubt avoid making the flap or switching to another procedure. While it may not be possible to entirely prevent post lasik ectasia, due diligence can decrease the incidence.