Case Reports

Bilateral central toxic keratopathy after LASIK

Case Report Details

First Author: M.Pauk Gulić CROATIA

Co Author(s):    I. Gabric   D. Gabrić                 

Abstract Details

Purpose:

Present a patient with bilateral central toxic keratopathy (CTK) after uneventful microkeratome assisted LASIK. We followed up the patient from day 0 to day 90. The patient followed the usual CTK presentation in everything but the fact that it was bilateral. OCT scans were used to differentiate between diffuse lamellar keratitis (DLK) and CTK to avoid treating the patient with the wrong protocol.

Setting:

University eye hospital Svjetlost, Zagreb, Croatia

Report of Case:

We present a female patient of 24 years of age who underwent uneventful myopic microkeratome assisted LASIK, she was seen on post-op day 1 and had no issues and reported binocular visual acuity of 0 in both eyes on the logMAR chart. On day 3 she reported blurry vision and an inability to focus on objects near and far. She was seen and a diffuse central corneal opacities that were photographed and logged. OCT showed typical findings for CTK and a decision was made to stop all medications and wait. At presentation, the patient showed a typical hyperopic shift with UCVA of 0.4 logMAR. We followed up with the patient weekly for the next 3 months and the patient showed full recovery of visual acuity.

Conclusion/Take Home Message:

When presented with a sudden loss of visual acuity in both eyes doctors should consider the possibility of bilateral CTK, not just DLK. If CTK is not recognized and treated as DLK it will cause permanent corneal deformation leading to an irreversible hyperopic shift.

Financial Disclosure:

None