Late onset post-LASIK keratectasia with reversal and stabilization after use of latanoprost and corneal collagen cross-linking

We report a case of late onset keratectasia after laser in situ keratomileusis (LASIK) and its quick reversal and stabilization after use of latanoprost and riboflavin/ultraviolet-A corneal collagen cross-linking (CXL). A 39-year-old man with normal intraocular pressure developed a rapid deterioration of vision in his left eye 6 years after LASIK-retreatment for high myopic astigmatism. Keratectasia was diagnosed by corneal topography and ultrasound pachymetry. After two months of treatment with latanoprost and a minor intraocular pressure reduction, uncorrected distance visual acuity improved from 20/100 to 20/20 and corneal topography showed reversal of keratectasia. CXL was performed after the reversal to achieve long-term stabilization. At 1, 3, 6, 13 and 39 months followup exams after the CXL, stable vision, refraction, and topography were registered. This case shows that keratectasia may rapidly occur several years after LASIK and that a quick reversal and stabilization may be achieved by use of latanoprost followed by CXL