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Phototherapeutic keratectomy combined with photorefractive keratectomy with mitomycin C for the treatment of corneal opacities after adenoviral keratoconjuntivis: a case report

Poster Details

First Author: C.Pérez Casaseca SPAIN

Co Author(s):    J. Garrido Linares   E. Espejo de los Riscos           

Abstract Details

Purpose:

To report the use of Phototherapeutic Keratectomy (PTK) combined with Photorefractive Keratectomy (PRK) with Mitomycin C (MMC) in a patient with chronic corneal infiltrates after adenoviral conjunctivitis with poor AV.

Setting:

Clinica Baviera, Málaga, Spain.

Methods:

We report the case of a 58 year old woman with chronic subepithelial infiltrates in her left eye after adenoviral conjunctivitis three years earlier, resistant to topical treatment. Her uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) was 20/80 and the refraction was +6.5 -5.5 x 95. The topography and pachimetry were not assessable for artifacts. We performed treatment with a 100 microns PTK, followed by +3.5 PRK with MMC 0.02% for 20 seconds. After six months we underwent retreatment with LASEK with MMC 0.02 % for a residual refractive error of -3.5 +3 x 100.

Results:

Six months after the last surgery, her UDVA was 20/25. The cornea was clear without haze or infiltrates, and the refraction was +0.5.

Conclusions:

Treatment of chronic subepithelial infiltrates with laser excimer is a therapeutic option in patients resistant to topical treatment , in which the only therapeutic option is a keratoplasty due to poor visual acuity. The combination of PTK and PRK with MMC represents a therapeutic alternative, that, as in the case presented, requires retreatment to achieve the desired refractive outcome. PTK treatment produces corneal flattening and hyperopic shift. Then if we combine it with a hyperopic PRK, we can achieve the removal of infiltrates with a refractive outcome that is treatable with a second procedure, LASEK in our case. FINANCIAL DISCLOUSRE: NONE

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