Lasik over RK Equals Ectasia

Below are photos of the right and left eye of a patient that underwent both Radial Keratotomy(RK) in the 1980″s followed by LASIK surgery in each eye about 15 years later. Shortly after undergoing LASIK, both of this patient’s eyes developed post-LASIK corneal ectasia. This patient has no functional vision with eyeglasses or conventional contact lenses. In order to obtain meaningful images, we instilled a special dye (fluorescein) onto each eye. In this way all of the defects on the ocular surface are readily visible. In these images note the dark green radial lines. These are the open RK incisions that are still open after all of these years. The green tinted circular line going around each cornea is the edge of the LASIK flap. The fact that you can see the dye within the flap tells you that the “seam” is open. The first 2 photos are of the left eye. Note the small green tinted round dot at 1:00. This is an inflamed area caused by loose suture. The suturing was done after cataract surgery to prevent any complications from the previous refractive surgeries. The 2nd image shows a more detailed view of this part of the left cornea. We removed the loose suture today and treated the inflammation. This patient was successfully fit with scleral lenses about 8 years ago and has had clear, comfortable vision with these lenses since then.