June consultation #3

If there is continued progression in a post-LASIK ectasia patient who has undergone CXL once, I would try to achieve stability with repeat CXL. It is not clear which type  of CXL this patient failed, but if he did not have epi-off CXL, I would perform this and monitor closely for diffuse lamellar keratitis or corneal melt. If for some reason the patient could not have epi-off CXL, I would recommend transepithelial CXL. I would monitor the riboflavin loading step ca refully to ensure adequate riboflavin penetration.
Source: Journal of Cataract and Refractive Surgery - Category: Opthalmology Authors: Tags: Consultation section: Refractive Source Type: research