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Early diagnosis and management of central toxic keratopathy (CTK): case report

Poster Details

First Author: G.Fernandez-Baca SPAIN

Co Author(s):    C. Perez Casaseca              

Abstract Details

Purpose:

To report a case of CTK following hyperopic femtolasik, with spontaneous resolution after 3 months. Initially treated as a DLK grade IV (steroids and irrigation) with no improvement, followed by observation and lubricants.

Setting:

Hospital Regional Universitario de Málaga (Spain)

Methods:

Case report of a 34 year old male, who undewent hyperopic femtolasik (Visumax, Carl Zeiss Meditec and MEL 80, Carl Zeiss Meditec). We observed a noninflamatory stromal opacification, and corneal thinnig in both eyes with posterior striae. We started with topical steroids, antibiotics and irrigation on the second day after surgery. As we did not observe neither anatomical nor functional improvement, the diagnosis of this patient was a CTK and began with steroids tapering. We have documented this case with topographies and anterior segment photographies, showing the evolution during three months

Results:

Eight days after the surgery, being diagnosed as a grade IV DLK (treated with steroids and flap irrigation) his CDVA was 20/50 (-0,75 cyl a 110, +0,50) in RE and 20/50 (-1 a 85, +0,75) in LE. This patient recovered his UCDVA to 20/30 in both eyes after 3 months with artificial tears treatment, progressively showing spontaneus clearance of the central opacification, refractive and topographic improvement . This case confirms the correct management of CTK cases

Conclusions:

CTK is a rare condition following refractive ablation procedures, this case matches with the typical findings of this entity ( initial DLK, noninflamatory central corneal opacification, stromal involvement, posterior striae and corneal thinnig). It is important to keep this entity in mind, when we face interface pathology after LASIK, specially in DLK cases without any response after intensive treatment

Financial Disclosure:

NONE

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