Corneal ectasia secondary to LASIK after arcuate keratotomy.

PURPOSE: To present a case of corneal ectasia after LASIK in a patient with previous arcuate keratotomy. METHODS: Case report. RESULTS: The patient underwent arcuate keratotomy in both eyes in 1997 for with-the-rule regular hyperopic astigmatism and uneventful bilateral LASIK for residual astigmatism 5 years later. Visual acuity and refraction remained stable for 5 years, when the patient noticed worsening visual acuity. Corneal topography showed progressive inferior steepening, confirming the diagnosis of ectasia. Corneal high-resolution optical coherence tomography revealed a normal LASIK flap. The patient had no risk factors for corneal ectasia other than previous incisional surgery. CONCLUSIONS: This case suggests that isolated arcuate keratotomy can be a significant risk factor for the development of corneal ectasia after LASIK.