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Case report of central toxic keratopathy (CTK): early diagnosis and management

Poster Details

First Author: M.Atencia Ballesteros SPAIN

Co Author(s):    J. Coin Ruiz   G. Fernandez-Baca Vaca                 

Abstract Details

Purpose:

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

Setting:

H.R.U de Malaga (Spain)

Methods:

Case report of a 38 year old female, who underwent hyperopic femtolasik (Visumax, Carl Zeiss Meditec and MEL 80, Carl Zeiss Meditec). A noninflamatory stromal opacification and corneal thinnig in both eyes with posterior striae was observed. On the second day after surgery we started with topical steroids, antibiotics and irrigation. As we did not observe neither anatomical nor functional improvement, the diagnosis of this patient was a CTK and began with steroids tapering. Topographies and anterior segment photographies show the evolution during three months.

Results:

One week approximately after the surgery, being diagnosed as a grade IV DLK (treated with steroids and flap irrigation) her CDVA was 20/50 (-0,75 cyl a 110, 50) in right eye (RE) and 20/50 (-1 a 85, 75) in left eye (LE). The patient recovered her 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.

Conclusions:

This case matches with the typical findings of CTK (noninflamatory central corneal opacification, initial DLK, posterior striae and corneal thinnig, stromal involvement). CTK is a rare condition following refractive ablation procedures but 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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