Surgical intervention in central toxic keratopathy.

Area of Science:

• Ophthalmology
• Corneal Surgery
• Refractive Surgery

Background:

• Central toxic keratopathy (CTK) is a rare but serious complication following refractive surgery.
• Prompt management is crucial to prevent significant visual impairment.

Purpose of the Study:

• To report the management and outcomes of three cases of bilateral central toxic keratopathy (CTK).
• To evaluate the effectiveness of surgical intervention versus medical management for CTK.

Main Methods:

• Retrospective chart review of three patients who developed bilateral CTK after laser-assisted in situ keratomileusis (LASIK).
• Analysis of management strategies including flap lifts and irrigation (FL+I) and medical management.
• Corneal imaging (Artemis II) to assess stromal changes.

Main Results:

• Patient A, treated with FL+I, achieved excellent unaided visual acuity in one eye and improved best-corrected visual acuity in the other.
• Patient B, also treated with FL+I, had good visual recovery in one eye but reduced acuity in the other.
• Patient C, managed medically, experienced a decline in visual acuity in one eye and partial recovery in the other.
• Artemis II imaging showed early stromal loss with subsequent partial recovery of stromal thickness in some cases.

Conclusions:

• Surgical intervention, specifically flap lifts and irrigation, may be beneficial in managing central toxic keratopathy (CTK) and improving clinical outcomes.
• Early detection and intervention are critical for managing CTK and mitigating visual loss after LASIK.