Pregnancy-Induced Post-LASIK Ectasia
Purpose
Iatrogenic keratectasia after LASIK represents a serious complication of laser refractive surgery. We describe a woman who developed unilateral iatrogenic keratectasia during her pregnancy.
Methods
Case report with relevant literature review.
Results
A 20-year-old woman, with a stable myopic astigmatism underwent LASIK for the correction of refractive error. Preoperative clinical examination and corneal topography did not suggest keratoconus in either eye. The patient had a preoperative corneal thickness of 527 and 525 microns, and a postoperative residual stromal bed of 313 and 325 microns in the right and left eyes, respectively. After good outcome of LASIK, she reported 42 months later during the first trimester of her second pregnancy a small deterioration in visual acuity in the right eye, linked with glare and halos. Over the next 7 months, the patient’s symptoms worsened and iatrogenic keratectasia was diagnosed. She was advised to undergo collagen crosslinking procedure in the affected eye.
Conclusion
Pregnancy induced hormonal changes may affect the biomechanical stability of the cornea, leading to corneal ectasia. We recommend closer follow up during pregnancy, and consider pregnancy as risk factor in the risk-benefit analysis during evaluation in women prior to LASIK, especially in borderline cases.