Bikbulatova A.A., Pasikova N.V.
IATROGENIC KERATECTASIA AS A LONG-TERM COMPLICATION OF ANTERIOR KERATOTOMY ^{[№ 12 ' 2015]}
Iatrogenic corneal ectasia is a serious complication of anterior keratotomy, leading to the decreasing of visual acuity and certain difficulties in further surgical rehabilitation. The urgency of the problem is no doubt due to the massive performance of anterior keratotomy for the correction of myopia and myopic astigmatism at the end of the last century and the increasing number repeat visits of the patients operated more than twenty years ago. Clinical signs of postkeratotomy corneal ectasia does not cover enough in the available literature. According to the results of our study, keratectasia may occur late after radial-tangential and radial keratotomy. Perforations during surgery, repeated keratotomy, crossing the radial by tangential cuts are risk factors for the development of iatrogenic ectasia. The clinical picture of secondary ectasia after keratotomy is characterized by severe refractive disorders in the form of hyperopic complex and mixed astigmatism, including a high degrees. Flattening and thickening of the central area of the cornea is accompanying by increased refraction in the peripheral regions and the emergence of irregular astigmatism. Protrusion of the peripheral parts of the cornea is combining with divergence of keratotomy scars, their differences and the formation of clear epithelial plugs between the edges of scars. In the area of protrusion the corneal stroma is thinning. Iatrogenic keratectasia, which developed in the late period after the anterior keratotomy, has specific refractive, keratometric, keratotopographic, pachimetric and biomicroscopic features. We study patients without family history of ectasia, eye injury, concomitant somatic pathology. This allows us to assume that the anterior keratotomy had become the reason of iatrogenic ectasia.