Automated lamellar therapeutic keratoplasty for post-PRK corneal scarring and thinning

Abstract

To present the use of automated lamellar therapeutic keratoplasty (ALTK) for the treatment of post-photorefractive keratectomy (PRK) corneal scarring and thinning with significant residual myopia. Interventional case report. A patient with high myopia of -12 diopters previously underwent PRK that resulted in corneal scarring, myopic regression, moderate loss of best-corrected visual acuity, a residual refractive error of -6.50/-1.00 x 175 degrees, and a remaining corneal thickness of 300 mum. ALTK was first performed to remove the scar and to augment corneal thickness, and a subsequent laser-assisted in-situ keratomileusis (LASIK) procedure was performed to correct the residual myopia. ALTK effectively removed the corneal scar and augmented the corneal thickness to 639 mum. LASIK effectively treated the residual myopia, resulting in an unaided visual acuity of 20/25 and a stable refractive error of plano/-0.50 x 40 degrees. The ALTK interface remained clear throughout the follow-up period of 26 months. ALTK may be a reasonable alternative to conventional penetrating keratoplasty in the treatment of post-PRK corneal scarring and thinning, with a moderate loss of best-corrected visual acuity, and LASIK can be subsequently performed to correct the residual refractive error and achieve an excellent refractive and visual outcome.