Corneal ectasia detected 32 months after LASIK for correction of myopia and asymmetric astigmatism.

We report a case of corneal ectasia detected 32 months after laser in situ keratomileusis (LASIK) for correction of -4.25 diopters (D) of myopia associated with -2.00 D of regular but slight asymmetric astigmatism. The patient retained stable visual acuity for 15 months postoperatively. The preoperative corneal thickness was 540 microm, and the postablation untouched stroma was assumed to be 290 microm. Although a rare complication of LASIK, corneal ectasia can occur, and there is no consensus regarding how much stroma should be left intact to avoid it. Until we have a better understanding of corneal strength, we think surface photorefractive keratectomy or laser-assisted subepithelial keratectomy ablations should be considered instead of LASIK in borderline cases.