ECTASIA AFTER REFRACTIVE SURGERY: EVALUATION AND CORRECTIVE APPROACH

Abstract

Introduction: Corneal ectasia after refractive surgery has emerged as a significant complication, affecting the visual quality and ocular integrity of patients who have undergone procedures such as LASIK and PRK. This condition, characterized by thinning and protrusion of the cornea, can arise insidiously, often after surgery, raising questions about the identification of risk factors and the need for corrective approaches. Understanding the mechanisms involved in ectasia, as well as the evolution of diagnostic and therapeutic methods, has become essential to improve postoperative results and the safety of refractive procedures. Objective: To analyze the available literature on corneal ectasia after refractive surgery, exploring evaluation strategies and corrective treatment options. Methodology: The research was conducted based on the PRISMA checklist, covering articles published in the last 10 years in the PubMed, Scielo and Web of Science databases. Five descriptors were used: "corneal ectasia", "refractive surgery", "LASIK", "PRK" and "corrective approach". The inclusion criteria were: studies that addressed cases of postsurgical ectasia, studies that detailed diagnostic methods and articles that presented therapeutic approaches. Publications that did not focus on ectasia, reviews without primary data and studies with samples smaller than 20 patients were excluded. Results: The review identified several predisposing factors for ectasia, such as the presence of keratoconus, topographic characteristics of the cornea and calculation errors in the selection of surgical parameters. The most effective diagnostic methods included corneal tomography and aberrometry, while corrective interventions ranged from intracorneal rings to lamellar transplant procedures. The literature has indicated that early detection and appropriate intervention can significantly improve visual outcomes. Conclusion: Corneal ectasia after refractive surgery is a complication that requires special attention. The literature review highlighted the importance of early diagnosis and implementation of appropriate corrective strategies to mitigate its effects. Understanding the risk factors and the evolution of treatment techniques are crucial to ensure the safety and efficacy of refractive procedures.