Abstract
To report topography-guided photorefractive keratectomy (PRK) with mitomycin C (MMC) after penetrating keratoplasty for keratoconus. A 34-year-old woman with irregular astigmatism after penetrating keratoplasty in the right eye underwent PRK. Topography-guided surface ablation using the customized aspheric treatment zone ablation (CATz) was programmed for a 5.00-mm optical zone and an 8.50-mm transition zone. Mitomycin C was applied to corneal stroma for 20 seconds immediately after excimer laser ablation. Two months after surgery, the patient was very satisfied with the refractive outcome. Best spectacle-corrected visual acuity was 20/20 with a manifest refraction of -0.50 diopters. No haze formation was detected at 6-month follow-up. A significant improvement in the central 3 mm of the axial topography was noted. Topography-guided ablation using MMC may be a reasonable alternative for the management of refractive error after penetrating keratoplasty.
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