Post-LASIK ectasia is detected 2 years after surgery in a 31-year-old. Pentacam shows progressive anterior elevation and thinning. Which treatment has the strongest evidence for halting ectasia progression?

• A Topography-guided LASIK re-treatment
• B Intrastromal corneal ring segment (ICRS) insertion alone
• C Intravitreal ranibizumab injection
• D Corneal collagen cross-linking (CXL) ✓

Explanation

Corneal collagen cross-linking (CXL) using riboflavin and UV-A radiation creates covalent bonds between collagen fibrils, stiffening the corneal stroma and halting ectasia progression with strong level-1 evidence. ICRS (Intacs, Kerarings) improves vision quality but does not halt the underlying biomechanical weakening. LASIK re-treatment on an ectatic cornea is absolutely contraindicated. Intravitreal ranibizumab has no role in corneal ectasia.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.