Induced Astigmatism After Diamond Burr Superficial Keratectomy for Recurrent Corneal Erosion

Abstract

To report a case of induced astigmatism after diamond burr superficial keratectomy (DBSK) for recurrent corneal erosion (RCE). Case report. Review of clinical findings in a 54-year-old women with ocular history of a scleral buckling procedure for a retinal detachment from blunt trauma and phacoemulsification with intraocular lens placement. The patient presented with RCE after trauma with a mascara brush to the OD and was treated with DBSK. Postoperatively, she developed significant astigmatism. In the third postoperative week after the DBSK procedure, the patient reported of worsening vision. On corneal topography, the patient was found to have 4 diopters of induced astigmatism. The astigmatic error was followed closely by serial corneal topography; a gradual decrease in the amount of astigmatism occurred over the course of 30 weeks. Forme fruste keratoconus was suspected in the patient's contralateral eye, based on corneal topographic analysis. Induced corneal astigmatism is a previously undescribed complication that can occur after DBSK. It is unclear whether the induced astigmatism in our patient was caused by the DBSK procedure alone or whether the patient had decompensated structural integrity from forme fruste keratoconus or blunt corneal trauma or both. The authors recommend that corneal topographic analysis be appropriately considered before DBSK for RCE and that corneal astigmatism be seen as a potential complication of the procedure.