Transepithelial phototherapeutic keratectomy and topography-guided photorefractive keratectomy with coadjuvant use of mitomycin C for the treatment of a central deep corneal scar

Session Details

Session Title: Presented Poster Session: Refractive

Venue: Poster Village: Pod 3

First Author: : M.Garcia-Gonzalez SPAIN

Co Author(s): :    J. Garcia-Perez   J. Gros-Otero   L. Alvarez-Rementeria Capelo                 

Abstract Details

Purpose:

To describe a case of a central deep corneal scar successfully treated with transepithelial phototherapeutic keratectomy (PTK) + topography-guided photorefractive keratectomy with the adjuvant use of 0.02% mitomycin C (MMC).

Setting:

Clinica Rementeria. Madrid. Spain

Methods:

A 18-year-old woman had a central corneal scar in her left eye, secondary to a microbial keratitis two years before. The preoperative corrected distance visual acuity (CDVA) was 0.4. Preoperative central corneal thickness (CCT) was 450 microns. Anterior segment optical coherence tomography (AS-OCT) showed an irregular stromal thinning compensated by an epithelial thickening. The corneal scar depth was 120 microns at the corneal apex, and 156 microns at the inferotemporal periphery. A transepithelial PTK of 50 microns was performed, followed by a topography-guided PRK of 50 microns. Therefore, 0.02% MMC was applied for 2 minutes over the ablated stroma.

Results:

On day 1,uncorrected visual acuity (UCVA) was 0.1.The medications consisted of topical ciprofloxacin 3mg/mL) and dexamethasone alcohol 1mg/mL drops four times daily during the first week postoperatively.At 1 week postop,UDVA was 0.3, the epithelial healing was completed and the therapeutic contact lens was removed. Steroid drops were tapered over the subsequent 2 months:three times daily the first month, twice daily for the following 15 days, and once daily for another 15 days.At 3 months postop, UDVA was 0.3 with a residual defect of +3.00 diopters and a CDVA of 0.8.The corneal topography showed improved regularity of the anterior corneal surface.

Conclusions:

Transepithelial PTK followed by topography-guided PRK + mitomycin C could be considered as an alternative to a deep anterior lamellar keratoplasty in cases of central corneal scars.

Financial Disclosure:

None