Management of Post Laser In Situ Keratomileusis Ectasia with Simultaneous Topography Guided Photorefractive Keratectomy and Collagen Cross-Linking

George D Kymionis1, Dimitra M Portaliou*, 1, Vasilios F Diakonis1, Alexandra E Karavitaki1, Sophia I Panagopoulou 1, Mirko R Jankov II 2, Efekan Coskunseven 3
1 Institute of Vision and Optics University of Crete, Greece
2 LaserFocus – Centre for Eye Microsurgery, Belgrade, Serbia
3 Dunya Eye Hospital, Istanbul, Turkey

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© Kymionis et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Institute of Vision and Optics (IVO), University of Crete, Medical School, 71003 Heraklion, Crete, Greece; Tel: +302810371800; Fax: +302810394653; E-mail:


A thirty-nine year old man was referred to our institute due to progressive decreased visual acuity five years after bilateral Laser in situ Keratomileusis (LASIK). Topography revealed signs of post – LASIK ectasia. Patients’ left eye was treated with simultaneous Topography Guided Photorefractive Keratectomy (PRK) followed by Corneal Collagen Cross Linking (CXL). Twelve months after the combined procedure both uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) showed significant improvement while topographic findings revealed an improvement of the astigmatic pattern. All higher order aberrations showed a significant decrease twelve months postoperatively. Combined topography guided PRK and corneal cross linking could represent an alternative treatment for post – LASIK ectasia.

Keywords: Post, LASIK ectasia, topography, guided PRK, CXL.