Keratectasia after bilateral laser in situ keratomileusis in a patient with previous radial and astigmatic keratotomy

We describe a case of bilateral keratectasia after laser in situ keratomileusis (LASIK) in a patient with previous radial keratotomy and astigmatic keratotomy. The best spectacle-corrected visual acuity (BSCVA) was 20/25 in both eyes. After uneventful LASIK was performed in both eyes for low myopic astigmatism, the patient presented with progressive myopia and astigmatism and a BSCVA of 20/50 in both eyes. Videokeratography showed progressive deformation of the cornea, increasing K-values over 50.0 diopters, and irregular astigmatism. The best corrected visual acuity in both eyes improved to 20/25 with rigid poly(methyl methacrylate) contact lenses.