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Central Toxic Keratopathy after Photorefractive Keratectomy: Two-Year Follow-Up Case Report and Review of the Literature

Year: 2025
Type: article
Study design: Case Report
Abstract: Purpose: To report a rare case of central toxic keratopathy (CTK) after photorefractive keratectomy (PRK). Methods: A 22-year-old male underwent bilateral PRK for the correction of myopic astigmatism. Preoperative refraction measurements were -2.50 -1.00 × 65 in the right eye and -3.50 diopter (D) sphere in the left eye. The intended refractive correction was -3.25 -1.00 × 65 (in the right eye) and -4.25 D sphere in the left eye. Preoperative corneal thickness measured 489 μm (in the right eye) and 491 μm in the left eye, both values exceeding the minimum safe threshold for PRK. Results: At the 1-week postoperative evaluation, slit-lamp examination and optical coherence tomography (OCT) revealed significant central corneal haziness, thinning, and flattening, along with hyperopic astigmatism. These findings were consistent with CTK. The surgeon adopted a conservative approach, closely monitoring the patient without initiating pharmacological intervention. By the 6-month follow-up, the patient demonstrated reduced hyperopia and achieved a best-corrected visual acuity of 20/20. OCT imaging also confirmed increased central corneal and epithelial thickness, suggesting progressive recovery. Long-term follow-up over 2 years showed stable refraction and corneal thickness, with no further significant changes. Conclusions: keratomileusis but also following other refractive surgery approaches. Enhancing clinical knowledge of both its presentation and differential diagnosis is essential to avoid any unnecessary interventions.
DOI: 10.4103/joco.joco_125_25
Authors: Javad Sadeghi, Negareh Yazdani, Mohammad-Reza Sedaghat, Iman Varshovi-Jaghargh
Language: English
Field: Medicine
Open Access status: diamond
OpenAlex ID: W7116041094
FWCI:
Cites: 20
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