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Case Reports and Small Case Series
February 2000

Iatrogenic Keratoconus: Corneal Ectasia Following Laser In Situ Keratomileusis for Myopia

Arch Ophthalmol. 2000;118(2):282-284. doi:

Laser in situ keratomileusis (LASIK) to correct myopia is performed by partially resecting a prescribed thickness of stroma, removing corneal tissue from the exposed stromal bed using the excimer laser, and then replacing the resected stromal tissue. This results in a substantial reduction of the biomechanically effective stress-bearing thickness of cornea provided by the residual stromal bed. There is concern that at some point, the tensile strength of the cornea might be reduced to the degree that progressive ectasia ensues, thereby resulting in steepening of the cornea, irregular astigmatism, and progressive myopia. This becomes a particularly contentious issue when, in the absence of classic clinical evidence of keratoconus, inferior steepening of the cornea seen on corneal topographic scan suggests the possibility of subclinical keratoconus. Herein, we report such a case of progressive ectasia following LASIK.