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Ectasia after keratorefractive surgery: Analysis of risk factors and treatment outcomes in the Indian population
PURPOSE: To analyze the risk factors in eyes developing ectasia following keratorefractive procedures. In addition, the study assessed visual outcomes following various treatment modalities for ectasia. METHODS: In this retrospective study, data of patients who underwent keratorefractive procedures,...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7508091/ https://www.ncbi.nlm.nih.gov/pubmed/32461422 http://dx.doi.org/10.4103/ijo.IJO_1580_19 |
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author | Soundarya, B Sachdev, Gitansha Shreyas Ramamurthy, Shreyas Dandapani, Ramamurthy |
author_facet | Soundarya, B Sachdev, Gitansha Shreyas Ramamurthy, Shreyas Dandapani, Ramamurthy |
author_sort | Soundarya, B |
collection | PubMed |
description | PURPOSE: To analyze the risk factors in eyes developing ectasia following keratorefractive procedures. In addition, the study assessed visual outcomes following various treatment modalities for ectasia. METHODS: In this retrospective study, data of patients who underwent keratorefractive procedures, presenting to the refractive services of a tertiary eye care hospital in South India between January 2016 and May 2019 was analyzed. Of these, the eyes that developed ectasia were noted and the possible risk factors were determined. Visual outcomes following treatment with corneal collagen crosslinking (CXL) with or without intracorneal ring segment implantation (ICRS) or topography-guided corneal ablation (T-PRK) were analyzed. RESULTS: Forty eyes of 26 patients developed ectasia following keratorefractive procedures, with a mean interval of 73.1± 45.4 months between primary procedure and ectasia development. Of these, 14 patients had bilateral presentation. Identifiable risk factors included ablation depth >75 μm (59.25%), percentage of tissue altered (PTA) >40% (48.14%), residual stromal bed <300 μm (22.22%), mean refractive spherical equivalent >8 D (25.92%), inferior–superior (I–S) asymmetry >1.4D (7.40%), central corneal thickness (CCT) <500 μm (7.40%), Belin Ambrosio Display (BAD) >2.5 (7.40%), posterior float elevation maximum ≥18 μm (3.70%), and pellucid marginal degeneration (PMD; 3.70%). CONCLUSION: Our study shows that only 70% of the eyes demonstrated an identifiable risk factor for the development of ectasia. Ablation depth of >75 μm and the PTA >40% were the most common risk factors. Treatment following CXL with ICRS or T-PRK demonstrated significantly better visual outcomes in comparison with CXL alone. |
format | Online Article Text |
id | pubmed-7508091 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-75080912020-10-02 Ectasia after keratorefractive surgery: Analysis of risk factors and treatment outcomes in the Indian population Soundarya, B Sachdev, Gitansha Shreyas Ramamurthy, Shreyas Dandapani, Ramamurthy Indian J Ophthalmol Original Article PURPOSE: To analyze the risk factors in eyes developing ectasia following keratorefractive procedures. In addition, the study assessed visual outcomes following various treatment modalities for ectasia. METHODS: In this retrospective study, data of patients who underwent keratorefractive procedures, presenting to the refractive services of a tertiary eye care hospital in South India between January 2016 and May 2019 was analyzed. Of these, the eyes that developed ectasia were noted and the possible risk factors were determined. Visual outcomes following treatment with corneal collagen crosslinking (CXL) with or without intracorneal ring segment implantation (ICRS) or topography-guided corneal ablation (T-PRK) were analyzed. RESULTS: Forty eyes of 26 patients developed ectasia following keratorefractive procedures, with a mean interval of 73.1± 45.4 months between primary procedure and ectasia development. Of these, 14 patients had bilateral presentation. Identifiable risk factors included ablation depth >75 μm (59.25%), percentage of tissue altered (PTA) >40% (48.14%), residual stromal bed <300 μm (22.22%), mean refractive spherical equivalent >8 D (25.92%), inferior–superior (I–S) asymmetry >1.4D (7.40%), central corneal thickness (CCT) <500 μm (7.40%), Belin Ambrosio Display (BAD) >2.5 (7.40%), posterior float elevation maximum ≥18 μm (3.70%), and pellucid marginal degeneration (PMD; 3.70%). CONCLUSION: Our study shows that only 70% of the eyes demonstrated an identifiable risk factor for the development of ectasia. Ablation depth of >75 μm and the PTA >40% were the most common risk factors. Treatment following CXL with ICRS or T-PRK demonstrated significantly better visual outcomes in comparison with CXL alone. Wolters Kluwer - Medknow 2020-06 2020-05-25 /pmc/articles/PMC7508091/ /pubmed/32461422 http://dx.doi.org/10.4103/ijo.IJO_1580_19 Text en Copyright: © 2020 Indian Journal of Ophthalmology http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Soundarya, B Sachdev, Gitansha Shreyas Ramamurthy, Shreyas Dandapani, Ramamurthy Ectasia after keratorefractive surgery: Analysis of risk factors and treatment outcomes in the Indian population |
title | Ectasia after keratorefractive surgery: Analysis of risk factors and treatment outcomes in the Indian population |
title_full | Ectasia after keratorefractive surgery: Analysis of risk factors and treatment outcomes in the Indian population |
title_fullStr | Ectasia after keratorefractive surgery: Analysis of risk factors and treatment outcomes in the Indian population |
title_full_unstemmed | Ectasia after keratorefractive surgery: Analysis of risk factors and treatment outcomes in the Indian population |
title_short | Ectasia after keratorefractive surgery: Analysis of risk factors and treatment outcomes in the Indian population |
title_sort | ectasia after keratorefractive surgery: analysis of risk factors and treatment outcomes in the indian population |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7508091/ https://www.ncbi.nlm.nih.gov/pubmed/32461422 http://dx.doi.org/10.4103/ijo.IJO_1580_19 |
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