Laser in situ keratomileusis combined with topography-supported customized ablation after repeated penetrating keratoplasty

I report the case of a 32-year-old woman who had penetrating keratoplasty (PKP) in both eyes because of keratoconus. After PKP, a high degree of spherical myopia and irregular astigmatism prevented optical correction. The patient then had laser in situ keratomileusis (LASIK) combined with topography-supported customized ablation (TOSCA) in both eyes. The procedure resulted in a significant reduction in spherical myopia and astigmatism. A tissue-sparing algorithm was used to plan the refractive treatment. There were no intraoperative or postoperative complications, and the treated corneas maintained transparency. TOSCA-supported LASIK is a useful method for dealing with specific refractive problems after PKP.