Central toxic keratopathy: a case study and literature review

Central toxic keratopathy (CTK) is a rare, non-inflammatory corneal opacity that can occur after corneal laser refractive surgery. It is characterized by the absence of inflammatory cells within the cornea or anterior chamber, central stromal necrosis, and corneal opacification, with an onset of 3 to 9 days after refractive surgery;

This case report reviews the clinical findings, differential diagnosis, possible etiologies, and management of CTK;

Though listed in the literature under numerous names, including diffuse lamellar keratitis (DLK) Stage IV, central lamellar keratitis (CLK), central flap necrosis (CFN), flap necrosis syndrome (FNS), and keratocyte-induced corneal microedema (KME), the conditions share characteristics with CTK, including clinical findings and treatment modalities. Treatment for CTK is controversial, though studies show best practices include close monitoring for possible corneal melt, avoiding topical corticosteroids, and possible enhancements for resultant hyperopia.