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ABSTRACT
Introduction: Corneal ectasia is a group of related diseases characterized by progressive corneal steepening and thinning. It includes keratoconus, pellucid marginal degeneration (PMD), and post-laser ectasia. Traditionally, treatment of these conditions has involved visual rehabilitation with spectacles or contact lenses, with often eventual need for corneal transplantation.
Areas covered: This review focuses on refractive surgery treatment options available for ectasia including collagen cross-linking (CXL), excimer laser, intrastromal corneal ring segments (ICRSs), and intraocular lenses (IOLs). A comprehensive literature review using OVID Medline and Embase was undertaken.
Expert commentary: CXL has shown promising short- and long-term results in stabilizing patients with corneal ectasia. When combined with excimer laser using topography- or wavefront-guided photorefractive keratectomy (PRK), many patients are able to gain significant improvements in visual acuity and contact lens tolerance, which may delay or prevent altogether the need for corneal transplantation. Other treatments such as ICRSs, phakic IOLs, and TORIC IOLs may be beneficial in select cases for visual rehabilitation.
Acknowledgement
The authors would like to thank Dana El-Saleh for her assistance with acquiring topography and treatment images.
Declaration of interest
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.