Unilateral Corneal Ectasia after Bilateral LASIK: The Thick Flap Counts

Valbon, Bruno de Freitas; Glicéria, Juliana; Santos, Ralmony de Alcântara; Alves, Mílton Ruiz

doi:10.5005/jp-journals-10025-1056

Cited by 7 publications

(3 citation statements)

References 17 publications

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“…Corneal ectasia has been a severe complication of LASIK surgery since the first report by Seiler in 1998 [ 27 ]. Clinical risk factors associated with ectasia include preoperative ectactic corneal disease, young age, and low preoperative pachymetry [ 21 , 28 , 29 , 30 ].…”

Section: Screening For Ectasia Risk Before Laser Vision Correctionmentioning

confidence: 99%

“…Some of these studies found a comparatively lower sensitivity for the VAE-NT eyes (some with typical topography and tomography—NTT). However, it is pertinent to note that various of these cases could be genuinely unilateral ectasia due to mechanical trauma [ 30 , 59 ]. Recently, a novel optimized version of the TBI (TBIv2) was developed with significantly higher accuracy (0.945) for detecting VAE-NT (84.4% sensitivity and 90.1% specificity; cutoff 0.43) and similar AUC for clinical ectasia (0.999; 98.7% sensitivity; 99.2% specificity; cutoff 0.8).…”

Section: Corneal Biomechanical Assessmentmentioning

confidence: 99%

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Enhanced Diagnostics for Corneal Ectatic Diseases: The Whats, the Whys, and the Hows

Esporcatte

Salomão

Neto³

et al. 2022

Diagnostics

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There are different fundamental diagnostic strategies for patients with ectatic corneal diseases (ECDs): screening, confirmation of the diagnosis, classification of the type of ECD, severity staging, prognostic assessment, and clinical follow-up. The conscious application of such strategies enables individualized treatments. The need for improved diagnostics of ECD is related to the advent of therapeutic refractive procedures that are considered prior to keratoplasty. Among such less invasive procedures, we include corneal crosslinking, customized ablations, and intracorneal ring segment implantation. Besides the paradigm shift in managing patients with ECD, enhancing the sensitivity to detect very mild forms of disease, and characterizing the inherent susceptibility for ectasia progression, became relevant for identifying patients at higher risk for progressive iatrogenic ectasia after laser vision correction (LVC). Moreover, the hypothesis that mild keratoconus is a risk factor for delivering a baby with Down’s syndrome potentially augments the relevance of the diagnostics of ECD. Multimodal refractive imaging involves different technologies, including Placido-disk corneal topography, Scheimpflug 3-D tomography, segmental or layered tomography with layered epithelial thickness using OCT (optical coherence tomography), and digital very high-frequency ultrasound (VHF-US), and ocular wavefront. Corneal biomechanical assessments and genetic and molecular biology tests have translated to clinical measurements. Artificial intelligence allows for the integration of a plethora of clinical data and has proven its relevance in facilitating clinical decisions, allowing personalized or individualized treatments.

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Section: Screening For Ectasia Risk Before Laser Vision Correctionmentioning

confidence: 99%

Section: Corneal Biomechanical Assessmentmentioning

confidence: 99%

Enhanced Diagnostics for Corneal Ectatic Diseases: The Whats, the Whys, and the Hows

Esporcatte

Salomão

Neto³

et al. 2022

Diagnostics

View full text Add to dashboard Cite

show abstract

“…[ 3 30 31 33 33 34 ] Although some of these studies have found a moderately lower sensitivity for the VAE-NT eyes (some with normal topography and tomography – NTT), it is important to a reminder that some cases may be truly unilateral ectasia due to mechanical trauma. [ 35 36 ]…”

Section: Ntegration Of C Orneal S ...mentioning

confidence: 99%