What is Corneal Ectasia?

Corneal ectasia is rare, but very severe. It is a complication of corrective surgery procedures to the eye. In corneal ectasia, procedures such as photorefractive keratectomy (PRK) and Laser-Assisted in-situ keratomileusis (LASIK) cause progressive thinning and bulging of the cornea, which in turn results in worsening vision.

Corneal ectasia is not a single entity. Instead, it is a group of conditions and complications of PRK and LASIK. The most common is known as keratoconus.

What Causes Corneal Ectasia?

In corneal ectasia, LASIK or PRK procedures remove too much tissue from the cornea, and causes a new form of astigmatism. The cornea becomes excessively thin and weak, and won’t be able to hold the normal eye pressure. Thus, it starts bulging out.

In keratoconus, the most common form of corneal ectasia, the collagen fibers of the cornea become weak, causing it to lose its structure and normal shape. This non-inflammatory and progressive condition makes the eye adopt a cone-like shape, affecting visual acuity in the process.

Contact lenses can also cause corneal ectasia, when they are either too rigid or too soft. This is why a board-certified professional should evaluate you before prescribing or recommending contact lenses. Otherwise, ill-fitting contact lenses mold the cornea and can cause the same symptoms as irregular astigmatism.

What are the Symptoms of Corneal Ectasia?

Corneal ectasia signs and symptoms are progressive as the cornea adopts a bulging shape. The most commonly reported are:

  • Inability to fully correct vision to 20/20 with contacts or glasses
  • Shadows or ghosting figures in the visual field
  • Refraction variations with constant prescription changes
  • Frequent squinting to improve visual acuity
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How is Corneal Ectasia Treated?

Corneal Cross-linking

Corneal cross-linking, also known as CXL, is a procedure designed to stabilize and strengthen the cornea through a minimally invasive approach consisting of UV light, eye drops, and brushing off the surface of the cornea.

It is appropriate for patients over 14 years of age, with mild or moderate symptoms. It can be performed in an office setting, and only takes around two hours including prep time, and treatment.

Intacs

These are implants that an ophthalmologist will place outside of the cornea to reduce its bulging shape. The implants are placed at two-thirds depth around the cornea, after making a small incision in the stroma. After Intacs, patients with keratoconus will be able to tolerate contact lenses once again, and it is an alternative to corneal transplantation.

Corneal Transplants

In moderate and severe cases, corneal transplants are a suitable option. It consists of replacing the cornea, but preserving a membrane known as Descemet membrane. The surgical technique is named DALK corneal transplant, also known as deep anterior lamellar keratoplasty. It is appropriate in cases of corneal scarring, advanced keratoconus, corneal ectasia after LASIK procedures, corneal degeneration and dystrophy.

DALK features a lower rejection rate compared to other procedures, with a rapid stabilization of the patient and healing of the wound. It also features quicker return to daily activities, including physical activity. Topical steroids can be prescribed after DALK, but only for a very short time to allow it to heal faster and
reduce the risk of cataracts and glaucoma.

It’s the right time for clearer vision

Our knowledgeable staff is here to answer all your questions about which procedure is best for you, and ensure you have the most comfortable experience possible. Make an appointment today!

If you are experiencing eye problems that affect your vision, LASIK laser eye surgery could be the answer. Talk to one of our surgeons to discover whether or not laser eye surgery is best for you. We are one of the best providers of laser eye treatments in Waxahachie, Texas. Call our laser eye care center at 469-505-2020.