Apparent Corneal Ectasia After Bilateral Intrastromal Femtosecond Laser Treatment for Presbyopia

Purpose: To report a case of apparent corneal ectasia after intrastromal femtosecond laser treatment for presbyopia (INTRACOR). Methods: A healthy 56-year-old male with low hyperopia underwent an unremarkable bilateral INTRACOR procedure in March/April 2011. The patient was discharged after follow-up and returned 5 years later. Results: Before discharge, the monocular logarithm of the minimal angle of resolution uncorrected distance visual acuity (UDVA) values were R, 0.0 and L, 0.10. In both eyes near (UNVA) visual acuities were 0.0. There were signs of slight posterior central corneal steepening without loss of corneal stability. Five years postop, monocular UDVA and UNVA values were 0.4 and 0.0, respectively. Ectasia was observed in both eyes, and the centrally placed 5 concentric rings after the INTRACOR procedure were visible under slit-lamp biomicroscopy. Conclusions: There is no clear reason to explain why the patient developed bilateral corneal steepening. It could be that the patient’s corneal stromal fibers gradually weakened over this 5-year period