Late onset of a persistent, deep stromal scarring after PRK and corneal cross-linking in a patient with forme fruste keratoconus

J Refract Surg. 2014 Apr;30(4):286-8. doi: 10.3928/1081597X-20140320-09.

Abstract

Purpose: To present a case of a late, deep stromal scar in a 22-year-old patient with forme fruste keratoconus who underwent combined corneal cross-linking and photorefractive keratectomy (PRK).

Methods: Topography-guided corneal cross-linking combined with corneal PRK (without complications) was performed in both eyes with a delay of 2 weeks between each eye.

Results: At the 5-month postoperative examination of the right eye, a localized corneal haze was circumscribed to the posterior deep stroma, signifying a decrease of visual acuity. However, this improved partially and temporarily when treated with topical corticoids during 2 years of follow-up and then reoccurred, affecting the corrected distance visual acuity.

Conclusions: To the authors' knowledge, this is the first documented, clinical case presenting a deep stromal affectation without endothelial decompensation and visual acuity affectation as a postoperative complication following topography-guided PRK and corneal cross-linking.

Publication types

  • Case Reports

MeSH terms

  • Cicatrix / diagnosis
  • Cicatrix / etiology*
  • Collagen / metabolism
  • Combined Modality Therapy
  • Corneal Diseases / diagnosis
  • Corneal Diseases / etiology*
  • Corneal Stroma / metabolism
  • Corneal Stroma / pathology*
  • Corneal Stroma / surgery
  • Corneal Topography
  • Cross-Linking Reagents / therapeutic use*
  • Humans
  • Keratoconus / drug therapy
  • Keratoconus / physiopathology
  • Keratoconus / surgery
  • Keratoconus / therapy*
  • Male
  • Photorefractive Keratectomy*
  • Photosensitizing Agents / therapeutic use
  • Postoperative Complications*
  • Riboflavin / therapeutic use
  • Ultraviolet Rays
  • Visual Acuity / physiology
  • Young Adult

Substances

  • Cross-Linking Reagents
  • Photosensitizing Agents
  • Collagen
  • Riboflavin