The Many Moods of Ectasia

Ectasia following refractive surgery is a dreaded complication that is poorly understood and hence often undetected. It can be caused by a multitude of modifiable and nonmodifiable factors, including inadequate preoperative screening, persistent eye rubbing, poor healing, hormonal fluctuations, subclinical inflammation of the ocular surface, and inherent genetic susceptibility. Collagen degradation is the hallmark of corneal ectasia, which is a cellular phenomenon, so it is prudent to study the molecular markers of ectasia. To give a wider group of patients the option of safer refractive surgery, we need to improve our diagnostics and make our screening more robust. This video is our attempt to elucidate the complex interplay between clinical factors, imaging, and molecular and genetic markers to better understand why we get ectasia and the different moods and modes of its presentation.