Corneal ectasia after hyperopic LASIK.

Purpose: To report two cases of corneal ectasia, which developed after hyperopic LASIK.
Methods: Preoperative pellucid marginal corneal degeneration was observed in patient 1. Patient 2 had no preoperative risk factors.
Results: Patient 1, a 47-year-old man, developed corneal ectasia in his right eye 6 months after unilateral hyperopic LASIK. Preoperative manifest refraction was +2.00 +1.50 x 178 in the right eye and +1.00 sphere in the left eye. Corneal thickness was 585 microm and 575 microm (right and left eye, respectively). Preoperative topography of the right eye demonstrated inferior steepening in the far periphery, suggestive of early pellucid marginal corneal degeneration. Patient 2, a 35-year-old man, developed corneal ectasia in his right eye > 3 years after bilateral LASIK. Preoperative manifest refraction was +2.50 sphere and +3.25 sphere (right and left eye, respectively), and corneal thickness was 556 microm in both eyes. Preoperative topography was normal in both eyes with no evidence of asymmetry, steepening, or irregularity.
Conclusions: Corneal ectasia can occur after hyperopic LASIK in patients with or without recognized preoperative risk factors. Although uncommon, patients with pellucid marginal corneal degeneration can have hyperopic refractions and are at high risk for developing corneal ectasia after LASIK.