A Case of Keratectasia 5 Years after Photorefractive Keratectomy

Kim, Sung Jin; Choi, Young In; Ghim, Dae Geun

Abstract

PURPOSE: The clinically evident keratectasia has not been reported after photorefractive keratectomy (PRK) on the eyes with normal preoperative corneal topography. Herein, we present a case of keratectasia developed 5 years after PRK.
METHODS
A 20-year-old man underwent the PRK for correction of myopic astigmatism in 1993. Preoperative manifest refractions were -4.00 D-0.50 D x 90degrees in the right eye and -3.75 D-0.75 D x 85degrees in the left eye. Although pachymetry was not performed, preoperative examinations including corneal topography did not show any sign of early keratoconus or forme fruste keratoconus. The operations were uneventfully performed on two eyes at an interval of one month.
RESULTS
Up to 9 months after PRK, the patient's uncorrected visual acuity had been maintained 1.2 in both eyes. When the patient returned 5 years after PRK, he complained of decreasing visual acuity (0.5)in his right eye. During the next 2 years, the vision of the right eye was deteriorated to 0.04, and could not be corrected with the spectacles. The corneal topography of the right eye revealed profound steepeningjust inferior to the corneal center, and he had become contact lens intolerant. The left eye remained stable. The central corneal thickness was 419.0 micrometerin the right eye and 476.3 micrometerin the left eye.