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Topical Minoxidil Solution-Induced Central Toxic Keratopathy following Photorefractive Keratectomy: A Case Study
Mehrdad Mohammadpour1, Masoud Khorrami-Nejad1, Mohsen Heirani1
1Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Purpose:
To report the clinical findings of unilateral central toxic keratopathy (CTK) associated with inadvertent exposure to topical minoxidil 5% solution 1 day after bilateral photorefractive keratectomy (PRK).
Methods:
Anterior segment slit-lamp photography, anterior segment optical coherence tomography (AS-OCT), pachymetry map, epithelial map, and manifest refractions were recorded.
Results:
This is a case of a 27-year-old male who underwent bilateral PRK and presented 5 days after surgery with the complaint of acute decreased visual acuity in the left eye (LE). His LE was reportedly exposed to topical ethanol-based minoxidil 5% on postoperative day 1, which he was using as a posthair transplant treatment. Clinical examination showed hyperopic shift, poor visual acuity, central corneal opacity, epithelial irregularity, central corneal thinning, and flattening on AS-OCT. These findings were consistent with a diagnosis of CTK. The patient was monitored with conservative treatment and demonstrated full recovery after 6 months.
Conclusion:
It is recommended to warn patients who have undergone refractive surgery concerning the use of ethanol-containing agents, such as minoxidil solution, because of the possible risk of CTK, a complication not formally recognized.

