June consultation #4

Keratectasia occurred in this case obviously because of the thick flap (423 μm − 189 μm means that the residual stromal bed thickness is 234 μm). This also explains the nonresponse to CXL. Hatami-Marbini and Jayaram1 showed that during CXL, only the anterior part of the cornea is stiffened, which means that mainly the flap was crosslinked with minor influence on the ov erall stiffness of the cornea. Another standard CXL would not make a difference, and a deeper CXL (longer imbibition, more ultraviolet-A) might become dangerous for the endothelium.
Source: Journal of Cataract and Refractive Surgery - Category: Opthalmology Authors: Tags: Consultation section: Refractive Source Type: research