Purpose: We describe a case of early onset keratectasia after photorefractive keratectomy (PRK) in a patient with Vertical D topographic pattern in one eye and suspected keratoconus in the other eye.
Methods: A 31-year-old woman underwent bilateral PRK: attempted correction was -8.00-2.00 × 30° in her right eye (RE) and -4.50-1.50 × 150° tabo in her left eye (LE). Preoperative corneal thickness was 512 µm in the RE and 520 µm in the LE. Preoperative topography showed an asymmetric bow-tie pattern and skewed axis in RE and a Vertical D pattern in LE. Intended maximum ablation was 91 µm in RE and 66 µm in LE.
Results: Three months postoperatively the patient showed early topographic signs of bilateral keratectasia, evolved to manifest keratectasia after six years.
Conclusions: Although rare after PRK, keratectasia may occur even following moderate (66 µm) surface ablation in eyes with Vertical D topographic pattern in one eye and controlateral suspected keratoconus.
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