J Korean Ophthalmol Soc.  2020 Jun;61(6):680-684. 10.3341/jkos.2020.61.6.680.

Central Toxic Keratopathy after Femtosecond Laser in-situ Keratomileusis

• Park SY
• Kwag JY
• Choi JS
• Pak KH
• Chung SK
• Hyun J

• KMID: 2502976
• DOI: http://doi.org/10.3341/jkos.2020.61.6.680

Abstract

Purpose
To report a case of central toxic keratopathy after femtosecond laser in-situ keratomileusis (LASIK).
Case summary
A 26-year-old male developed diffuse lamellar keratitis bilaterally on day 2 after femtosecond LASIK. He was applying topical steroid frequently, while also using topical antibiotics. On day 6 after LASIK, slit-lamp biomicroscopy showed a thick central corneal opacity on the right eye so a flap irrigation was performed. He was then treated with systemic methylprednisolone. A corneal epithelial crack and stromal striae were noted by slit-lamp biomicroscopy on postoperative day 10. Four weeks after LASIK, the refractive error was +4.25 Dsph = -1.25 Dcyl Axis 80°. He was treated with topical steroid, topical antibiotics, and oral doxycycline until eight weeks after LASIK. Eight weeks after LASIK, the patient was observed without treatment. The central corneal thickness recovered from 488 μm at eight weeks to 540 μm, and the refractive error was +1.25 Dsph = -0.75 Dcyl Axis 85° at postoperative 72 weeks. The central corneal opacity also recovered.
Conclusions
Because femtosecond LASIK may result in a combination of diffuse lamellar keratitis and central toxic keratopathy, the clinical characteristics and natural course of both diseases should be understood and timely treatment should be available.

Keyword

Central toxic keratopathy; Diffuse lamellar keratitis; Laser in situ keratomileusis