Ectasia after LASIK: new treatments, new hope.

摘要

Corneal ectasia remains a rare but potentially devastating complication after LASIK. In the past, treatment options have been limited; however, exciting advances have expanded our alternatives for visual rehabilitation. Any effective management strategy for ectasia after LASIK will encompass three fundamental principles: 1) halt the ec-tatic process; 2) reduce corneal curvature irregularity; and 3) correct the residual refractive error. Corneal collagen cross-linking (CXL) retards, aborts, or in many cases, partially reverses the ectatic process in eyes with keratoconus and ectasia after LASIK as measured by simple metrics (visual acuity and corneal steepness). However, quantifying the CXL effect in greater detail has proven more challenging. In this issue, Reinstein and colleagues1 report a novel technique for monitoring changes in the ectatic cornea after CXL treatment. Using Artemis very high-frequency digital ultrasound (ArcScan Inc, Morrison, Colorado], they were able to demonstrate epithelial remodeling after CXL, which may be a more sensitive indicator of treatment efficacy than current metrics. This modality could prove beneficial in monitoring success of CXL treatments, especially with the variety of techniques available on the horizon.