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Laser refractive surgery can be treatment option in some cases of keratoconus
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PARIS — Keratoconus is classically considered a contraindication for laser refractive surgery, and refractive surgery itself, especially LASIK, is known to be a potential cause of ectasia.
However, in specific cases, laser refractive surgery can be a valuable and safe treatment option for keratoconus, according to Joseph Colin, MD.
"[Phototherapeutic keratectomy] can be used to remove superficial opacities and subepithelial scars in patients intolerant to contact lenses. We have had cases where this procedure has allowed a new adaptation to contact lenses," Dr. Colin said at the meeting of the French Society of Ophthalmology. "In some cases of mild to moderate keratoconus, PRK can be a good option to improve vision, and even LASIK can be used to treat myopic astigmatism in some keratoconus patients."
However, careful patient selection and evaluation of preoperative parameters, as well as close monitoring of keratoconus patients who undergo laser refractive procedures, are mandatory, he said.
Alternative techniques such as Intacs (Addition Technology) and cross-linking are now available and can be an interesting complement to photoablation, increasing the safety and efficacy of the laser procedure.