Lasik, then Ectasia, then PRK, then Haze

The 2 images below are of the same eye. This patient’s eye underwent LASIK surgery 5 years ago. Several years later this eye developed post-LASIK corneal ectasia. After this diagnosis was made, it was suggested that this patient undergo PRK (photo refractive keratectomy) surgery to make this cornea more spherical. The first photo shows this cornea after the LASIK-PRK surgeries were done. Look carefully and note the circular line at 6:00 and 5:00 o’clock. This is the seam of the LASIK flap. Note the cloudy areas below the pupil. This is the corneal haze created by the PRK surgery. The 2nd image is a 3-D computer enhanced model of this cornea showing the extreme corneal distortion. If this was a “normal” cornea, the front corneal curve would be smooth and spherical. This patient is wearing a scleral lens over this eye which is allowing him to see clearly (20/25) without distortions. The bottom line is that the PRK surgery created additional problems for this patient. In my opinion, he would have been better off not getting involved with any additional procedures.