Contact lens management of keratectasia after laser in situ keratomileusis for myopia

Purpose. To present a case in which rigid gas-permeable contact lenses were fit for a patient in whom keratectasia developed after laser in situ keratomileusis (LASIK). Methods. Case report. Results. A 21-year-old man underwent bilateral LASIK for myopia and astigmatism. The left eye was only partially corrected because of high myopia and corneal thickness restrictions. Eight months after LASIK, visual acuity was reduced in the right eye; the central cornea had steepened; and pachymetry showed central corneal thinning. Keratectasia was diagnosed, and rigid contact lenses were fitted. Four years later, the patient achieved satisfactory visual acuity and all-day lens wear with minimal complications. Conclusions. The options for management of iatrogenic keratectasia include contact lenses, intracorneal ring segments, and penetrating keratoplasty. This case report shows that rigid contact lenses offer a safe, reversible option for improving visual acuity in such patients by delaying or avoiding the need for further surgical intervention. © 2004 Contact Lens Association of Ophthalmologists, Inc.