Hyperopic Photorefractive Keratectomy With Adjunctive Topical Mitomycin C for Refractive Error After Penetrating Keratoplasty for Keratoconus

Abstract

To present a case of photorefractive keratectomy (PRK) with adjunctive topical mitomycin C (MMC) in an anisometropic hyperopic patient after penetrating keratoplasty (PKP) for keratoconus. Interventional case report, chart review, and literature review. A 43-year-old man with a refraction of +7.00 -4.75 x 125 in the right eye underwent PRK 10 months after PKP for keratoconus. The patient had sutures removed for 3 months and was intolerant of contact lenses. After photoablation, 0.02% MMC was applied to the corneal stromal bed. The patient was followed up daily until the epithelium closed and at 1 week, 1 month, 3 months, and 6 months postoperatively. To our knowledge, this represents the first reported case of the use of MMC to prevent postoperative haze after PRK for PKP in an eye with keratoconus. MMC (0.02%) applied topically to the cornea immediately after PRK is safe and effective to treat a hyperopic refractive error after PKP and prevent postoperative corneal haze formation without the risks of performing a lamellar flap into an ectatic corneal bed.