Corneal Collagen Crosslinking for Progressive Post-Laser In Situ Keratomileusis Ectasia in Patients Older Than 50 years: A Case Series.

Purpose: Post-laser in situ keratomileusis (LASIK) ectasia has been rarely reported in older patients. We present the ectasia progression and treatment outcomes after corneal collagen crosslinking (CXL) in 5 patients with post-LASIK ectasia aged older than 50 years.

Methods: This retrospective case series included patients with post-LASIK ectasia. Primary outcome parameters included preoperative and postoperative best corrected distance visual acuity (logMAR best corrected visual acuity). Corneal topography values included maximum keratometry (Kmax), flat keratometry (K1), and steep keratometry (K2). All patients underwent epithelium-off CXL using the Dresden protocol.

Results: Five eyes of 5 patients were included. The mean patient age at CXL was 62.8 years (range 51-73 years). The average time since laser in situ keratomileusis surgery was 19 years (range 16-24 years). Patients were followed preoperatively for 343 days ± 150 and postoperatively for 3 to 5 years. Postoperatively, flattening of K2 and improvement in logMAR best corrected visual acuity were noted in all patients. There were no intraoperative or postoperative complications.

Conclusions: Unlike primary corneal ectasia, post-LASIK corneal ectasia progresses in older patients. Our results support that CXL is effective in patients with post-LASIK ectasia aged older than 50 years.