Corneal Ectasia: Ectasia Post LASIK Managed by Femtosecond-Assisted Deep Anterior Lamellar Keratoplasty (DALK)
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Corneal ectasia is one of the most serious complications of laser in situ keratomileusis (LASIK), with an estimated incidence between 0.04 and 0.66 % [1–3]. The main symptoms are progressive myopia, irregular astigmatism, and loss of corrected distance visual acuity (CDVA) . Risk factors for these complications are high myopia, undiagnosed forme fruste keratoconus, low residual stromal bed thickness, a large optical zone, and multiple enhancement procedures.
KeywordsHigh Myopia Corneal Stroma Anterior Segment Optical Coherence Tomography Central Scarring Deep Anterior Lamellar Keratoplasty
Femtosecond-assisted DALK was performed. Mushroom profile was applied. The same profile was applied on corneal donor tissue. Using a 45° angulated knife, 2/3 of the sclera was removed. A vertical limbal-scleral incision of 1 mm with a depth of 0.5 mm was created at the limbus in order to approach the Schwalbe line. A 29 gauge needle was inserted through the scleral incision targeting the Schwalbe line in order to achieve the big bubble through a lateral approach. Air was injected laterally creating the dissection of Descemet’s membrane. The air accumulated in the periphery served as a guide and disappeared in 24 h. The dissection of the residual stroma was performed until Descemet’s membrane was completely free of stromal tissue. Corneal button was then sutured with nylon 10.0 (MP4 14860 kb)