Post-Surgery Ectasia: A Complete Guide to Restoring Your Vision
Refractive surgeries like LASIK and PRK have successfully helped millions of people achieve clear vision. However, in a small percentage of cases, a serious complication can arise, sometimes years after the initial procedure: post-surgery ectasia.
Receiving this diagnosis can be frightening and confusing. You thought your vision problems were solved, and now you’re facing new challenges with blurriness, glare, and distortion. The good news is that there are modern, highly effective, non-surgical treatments available to restore your vision and comfort.
At Michigan Contact Lens, we specialize in the non-surgical management of complex corneal conditions, including post-refractive surgery ectasia. This guide will explain what post-surgery ectasia is, its causes and symptoms, and the advanced treatment options we provide for patients across Michigan.
Chapter 1: Understanding Your Diagnosis: What is Post-Surgery Ectasia?
Post-surgery ectasia is a condition where the cornea—the clear front surface of the eye—progressively thins and begins to bulge forward into an irregular, cone-like shape after a refractive procedure. This weakening and bulging disrupts the eye’s ability to focus light correctly, leading to a significant decline in vision quality.
Post-LASIK Ectasia vs. Post-PRK Ectasia
While the underlying issue is the same, the condition is most commonly known as post-LASIK ectasia. This is because LASIK involves creating a corneal flap, which can slightly reduce the structural integrity of the cornea. Ectasia can also occur after PRK, though it is less common, and is referred to as corneal ectasia after PRK.
Regardless of the original surgery, the treatment approach focuses on two goals: stabilizing the cornea to prevent further progression and restoring clear vision with specialty devices.
Chapter 2: What Causes Post-Surgery Ectasia and Am I at Risk?
Ectasia occurs when the cornea is no longer strong enough to maintain its proper shape against the eye’s natural internal pressure. The primary cause is the removal of too much corneal tissue during the original surgery, or performing surgery on a cornea that had an underlying, undetected weakness.
Key risk factors include:
- Undiagnosed Keratoconus: The most significant risk factor is having a pre-existing, mild form of keratoconus that was not detected before surgery. This is why our role as a keratoconus specialist in Michigan is so vital in both pre- and post-operative care.
- Thin Corneas: Individuals with naturally thin corneas are at higher risk.
- High Prescriptions: Correcting a very high degree of nearsightedness requires removing more tissue, which can increase the risk.
- Excessive Eye Rubbing: Chronic and aggressive eye rubbing can contribute to corneal weakening over time.
Chapter 3: Recognizing the Symptoms of Corneal Ectasia
The symptoms of corneal ectasia after surgery can develop gradually, often appearing months or even many years after the procedure. It’s crucial to report any new vision changes to your eye doctor immediately.
Increasing Blurriness and Ghosting
The most common symptom is a progressive blurring and distortion of vision that cannot be corrected with new glasses. You may notice “ghosting” or double images, especially around text or lights.
Frequent Changes in Your Prescription
If you find that your glasses prescription, particularly your astigmatism, is changing significantly at every eye exam, it is a major red flag for corneal instability and potential ectasia.
New or Worsening Halos and Glare
While some glare is common after refractive surgery, a noticeable increase in halos, starbursts, or general light sensitivity can be a key symptom of developing ectasia.
Chapter 4: The Modern Approach to Post-Surgery Ectasia Treatment in Michigan
The primary goal of modern care is to use the least invasive methods possible to achieve both stability and clear vision. At our Michigan clinic, we focus on a two-pronged, non-surgical approach for the treatment for post-surgery ectasia.
Part 1: Restoring Vision with Specialty Contact Lenses
Standard glasses and soft contacts cannot correct the vision problems caused by ectasia. The definitive solution is a custom-designed specialty lens that vaults over the irregular cornea.
Scleral Lenses After LASIK
The gold standard for correcting vision in ectasia is a scleral lens. These large-diameter lenses create a perfectly smooth optical surface and a fluid-filled reservoir that neutralizes all corneal irregularities. For patients seeking scleral lenses after LASIK in Michigan, this technology offers a life-changing improvement in visual clarity and comfort.
Hybrid and RGP Lenses
In some cases, smaller RGP lenses or hybrid lenses (with a hard center and soft skirt) may also be effective options. Our specialists will determine the best device for your unique eye shape during your fitting.
Part 2: Stabilizing the Cornea with Corneal Cross-Linking (CXL)
While scleral lenses correct the vision, they do not stop the ectasia from progressing. Corneal cross-linking for ectasia is a minimally invasive medical procedure designed to strengthen the cornea and halt the progression of the condition. It works by using a combination of riboflavin (Vitamin B2) eye drops and a controlled application of UV light to create new, strong bonds between the collagen fibers in the cornea.
CXL is often performed first to stabilize the eye. After the cornea is stable, a scleral lens fitting is performed to provide the best possible vision. This combination of CXL and scleral lenses is the modern standard of care for managing post refractive surgery ectasia.
Hybrid Lenses
Hybrid contact lenses are a type of contact lens that combines the best features of both hard (rigid gas permeable) and soft contact lenses. These lenses have a hard center that helps to correct vision, surrounded by a soft, flexible outer skirt that helps to provide comfort. Hybrid contact lenses can be a good option for people who have trouble wearing traditional hard or soft contact lenses. They may be especially helpful for people with irregular corneas or who have had refractive surgery, as the hard center can help to correct vision in these cases. Like other contact lenses, hybrid lenses require proper fitting and care to ensure safe and comfortable use.
Corneal Collagen Crosslinking
Corneal Collagen Crosslinking (CXL) is another treatment option for patients with keratoconus or post-PRK ectasia. CXL is a minimally invasive in-office procedure that strengthens the cornea by creating strong bonds (crosslinks) between corneal collagen fibers, halting the progression of these conditions. Clinical studies have shown that CXL not only stops the progression of keratoconus but also flattens the cornea and may improve vision. In combination with scleral contact lenses, CXL and scleral lenses provide the best treatment for post-PRK ectasia and keratoconus, with scleral lenses helping to improve vision and CXL stabilizing the cornea. For more information on CXL, please contact us.
Contact Lenses for Post-Surgery Ectasia FAQs
Yes, contact lenses are often the primary mode of vision correction for individuals with Post Lasik Ectasia. Specialty contact lenses, specifically designed for irregular corneas, can help improve visual acuity and minimize the distortions caused by ectatic corneas.
There are various types of contact lenses that can be used for Post-Surgery Ectasia, depending on the severity and individual needs. Some common options include soft toric lenses, rigid gas permeable (RGP) lenses, hybrid lenses, and scleral lenses. The choice of lens type will be determined by your eye care professional after a thorough examination.
Soft toric lenses are soft contact lenses with astigmatism correction. They are suitable for milder forms of Post-Surgery Ectasia where the irregularities of the cornea are not as pronounced. These lenses are comfortable and offer good vision for some individuals with ectatic corneas.
Scleral lenses are large-diameter lenses that vault over the entire cornea and rest on the sclera (the white part of the eye). These lenses create a tear-filled reservoir between the lens and the cornea, improving vision by bypassing the irregularities of the corneal surface. Scleral lenses are often considered the gold standard for managing advanced cases of Post-Surgery Ectasia, offering optimal visual acuity and comfort.
It is crucial to follow your eye care professional’s recommended schedule for contact lens fittings and check-ups. Initially, frequent visits may be necessary to ensure the proper fit and prescription of your contact lenses. Subsequently, regular follow-ups are essential to monitor the health of your eyes and make any necessary adjustments to your contact lens prescription or type.
While contact lenses are the most common and effective method for managing Post-Surgery Ectasia, there are alternative treatments available. These may include corneal collagen cross-linking (CXL), intrastromal corneal ring segments (ICRS), or, in severe cases, corneal transplant surgery. However, the suitability of these options will depend on the specifics of your condition, and it is important to consult with a qualified eye care professional to determine the best course of treatment for you.
Please call our eye specialists near you for more Keratoconus information.
Michigan Contact Lens Specialists
If you’re in need of a specialty contact lens or have been having a hard time getting fitted with soft contact lenses, call MCL today!
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