Refractive surgery in patients with ectasia

ABSTRACTIntroduction: Corneal ectasia is a group of related diseases characterized by progressive corneal steepening and thinning. It includes keratoconus, pellucid marginal degeneration (PMD), and post-laser ectasia. Traditionally, treatment of these conditions has involved visual rehabilitation with spectacles or contact lenses, with often eventual need for corneal transplantation.Areas covered: This review focuses on refractive surgery treatment options available for ectasia including collagen cross-linking (CXL), excimer laser, intrastromal corneal ring segments (ICRSs), and intraocular lenses (IOLs). A comprehensive literature review using OVID Medline and Embase was undertaken.Expert commentary: CXL has shown promising short- and long-term results in stabilizing patients with corneal ectasia. When combined with excimer laser using topography- or wavefront-guided photorefractive keratectomy (PRK), many patients are able to gain significant improvements in visual acuity and contact lens tolerance, whi...