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Journal of Ophthalmology
Volume 2017, Article ID 2434830, 10 pages
Research Article

Risk Assessment for Corneal Ectasia following Photorefractive Keratectomy

1Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
2Care Laser Inc., Tel Aviv, Israel
3Department of Ophthalmology, Barzilai Medical Center, Ashkelon, Israel
4Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel

Correspondence should be addressed to Nir Sorkin; moc.oohay@nikros_rin

Received 14 January 2017; Revised 11 April 2017; Accepted 26 April 2017; Published 26 July 2017

Academic Editor: Antonio Queiros

Copyright © 2017 Nir Sorkin et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purpose. To analyze the risk factors associated with a series of ectasia cases following photorefractive keratectomy (PRK) and all published cases. Methods. In a retrospective study on post-PRK ectasia patients, 9 eyes of 7 patients were included, in addition to 20 eyes of 13 patients from the literature. Risk of post-PRK ectasia was calculated using the ectasia risk score system (ERSS) for laser in situ keratomileusis (LASIK) patients. The percent tissue altered (PTA) was also evaluated. Results. ERSS scoring of zero for age, RSB, and spherical equivalent was found in 66%, 86%, and 86% of the eyes, respectively. Pachymetry risk score was 2 in 60% of the eyes and 3 or 4 in 16% of the eyes. Topography risk score was 3 in 41% of the eyes and 4 in 21% of the eyes. Cumulative ectasia risk score was ≥4 (high risk) in 77% of the eyes and ≥3 (medium and high risk) in 86% of the eyes. Average PTA was 23.2 ± 7.0%. All eyes but one had a PTA < 40%. Conclusions. Preoperative corneal topographic abnormalities and thin corneas may be significant risk factors for developing ectasia following PRK. Post-LASIK ectasia risk scoring also has relevance in the risk for developing post-PRK ectasia.