Thick Flap–Related Ectasia

Salomão, Marcella

Thick Flap–Related Ectasia

Friday, April 25, 2014

KIOSKS (Boston Convention and Exhibition Center)

Marcella Salomão, MD, Barra Vision Center, Rio de Janeiro, Brazil

Isaac C. Ramos, MD, Hospital de Olhos Santa Luzia, Maceió-AL, Brazil

Bruno F. Valbon, MD, University of São Paulo, Niterói, Brazil

Rosane Correa, MD, Rio de Janeiro Corneal Tomography and Biomechanical Study Group, Rio de Janeiro, Brazil

Lia Florim Patrão, MD, HOSPITAL DE OLHOS NITEROI, NITEROI, Brazil

Renato Ambrósio Jr., MD, PhD, Inst. Olhos R. Ambrósio, Rio de Janeiro, Brazil

Narrative Responses:

Purpose
To describe a case series of post-LASIK ectasia related to thick lamellar cuts.

Methods
Case series review of eyes that developed ectasia after patients underwent LASIK surgery where thick flaps were created.

Results
All cases had preoperative screening tests indicating low risk of ectasia development, based on criteria by the Ectasia Risk Score System (ERSS), including normal topography, residual stromal bed, corneal thickness, spherical equivalent and age. Both eyes of two patients and one eye of three patients developed post-LASIK ectasia due to thick flaps. Fellow eyes with stable outcomes had thinner flaps and residual stromal bed higher than 300 microns, measured by either Scheimpflug or Fourier Domain technology; while eyes that developed ectasia had residual stromal bed thinner than 300 microns.

Conclusion
Biomechanical failure may occur due to thick flaps in eyes with no identifiable preoperative abnormalities or with low risk factors.