Purpose: To alert ophthalmologists of the possibility of iatrogenic corneal ectasia following PRK in cases with bowing
posterior corneal float in otherwise normal topography.
Methods: Clinical case report of bilateral standard PRK for low myopia, with retrospective analysis of corneal
topography, visual acuity and corneal thickness.
Results: Corneal ectasia occurred bilaterally after PRK. Retrospective analysis of preoperative videokeratography
indicated the existence of high posterior corneal elevation.
Conclusion: This article is the first case report of a bilateral corneal ectasia after PRK for low myopia in patients with
normal placido topography. Even if there is no direct proof to demonstrate whether posterior corneal elevation or
thin cornea was the risk factor responsible for the evolution of keratoconus, the safety of the PRK procedure in
patients with isolated posterior elevation must be considered.