PURPOSE: To report the clinical features, management, and outcome of a patient who developed bilateral ectasia after photorefractive keratectomy (PRK). METHODS: Case report of a 35-year-old man who underwent bilateral PRK. Preoperative uncorrected visual acuity was 20/200 in the right eye and 20/100 in the left eye. The patient's history was unremarkable and he denied a family history of ocular disorders. RESULTS: Two weeks after surgery, the patient presented with loss of visual acuity in both eyes. Uncorrected visual acuity was 20/80 in the right eye and 20/200 in the left eye. Objective refraction could not be obtained. Slit-lamp microscopy showed corneal thinning in both eyes. After examining the patient's family, his sister was found to have clinical and topographic keratoconus. CONCLUSIONS: Ectasia is a rare complication of PRK. We report the occurrence of bilateral ectasia after PRK in a patient with asymmetric bowtie topographies. We recommend that refractive surgery, even surface techniques such as PRK, be avoided in patients with a family history of keratoconus. [J Refract Surg. 2007;23:941-943.]

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Estudiar el cambio en la velocidad de epitelización corneal en pacientes sometidos a cirugía de queratectomía fotorrefractiva de superficie en los que se aplicó trehalosa al 3%. Método: Se trata de un ensayo clínico prospectivo, aleatorizado y controlado. Los criterios de inclusión fueron ser mayor de 18 años, con criterios clínicos y topográficos para realizar cirugía refractiva, y aceptar participar en el protocolo. La asignación aleatoria se llevó a cabo para asignar a uno de los dos ojos de cada paciente para conformar el grupo control con el tratamiento convencional y el grupo de tratamiento con la instilación, además del tratamiento convencional, de trehalosa al 3%. Para cuantificar el área de desepitelización en milímetros cuadrados se utilizó el software libre de procesamiento de imágenes Image J. Resultados: El promedio de días de epitelización en el grupo de casos fue de 2.984 días y en el grupo de control fue de 2.954 días (diferencia no estadísticamente significativa; p = 0.1624063). El área de desepitelización en la revisión previa a alcanzar el 100% de epitelización en el grupo de casos fue de 4.255 mm 2 y en el grupo de control fue de 3.1762 mm 2 (diferencia no estadísticamente significativa; p = 0.0899374). Conclusiones: La trehalosa tópica al 3% no aumenta la velocidad de epitelización corneal en pacientes sometidos a queratectomía fotorrefractiva.

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Purpose: To study the changes in corneal re-epithelialization rate in patients undergoing surface photorefractive keratectomy by using 3% trehalose. Methods: This is a prospective, randomized, controlled clinical trial.The inclusion criteria were patients older than 18 years, with clinical and topographic criteria for refractive surgery, who agreed to participate in the protocol. Randomization was carried out to assign one eye of each patient to the control group with conventional treatment and the other eye to the experimental group with 3% trehalose plus conventional treatment. The free image processing software Image J was used to quantify the area of de-epithelialization in square millimeters. Results: The average number of epithelialization days was of 2.984 days in the experimental group and of 2.954 days in the control group (not statistically significant; p = 0.1624063). The area of de-epithelialization in the examination prior to reaching 100% epithelialization was of 4.255 mm 2 in the experimental group and 3.1762 mm 2 in the control group (not statistically significant; p = 0.0899374). Conclusions: Topical instillation of 3% trehalose does not increase the rate of corneal re-epithelialization in patients undergoing photorefractive keratectomy.