ABSTRACT
To report a case of a 20-year-old woman who developed massive and progressive corneal remodeling in both eyes after bilateral PRK with mitomycin and CXL as an elective refractive procedure for mild keratoconus. The patient had 6 years of follow up, initially presenting with focal steepening of up to 20 diopters on both eyes one-and-a-half- years postoperatively that spontaneously reversed over the next five years while the high order aberrations worsened. At the present time, the patient depends on bilateral scleral contact lenses for her day-to-day activities. The use of combined elective PRK with mitomycin and prophylactic CXL could lead to progressive corneal deformation. Additional reports would help to establish the role of this combination procedure among the armamentarium to visually rehabilitate patients with keratoconus.
ABSTRACT
A 15-year-old boy had deep anterior lamellar keratoplasty in the right eye and intracorneal ring segments/corneal crosslinking in the left eye for the treatment of progressive keratoconus due to eye rubbing. He achieved a good surgical results, and 6 months later, the uncorrected distance visual acuity (UDVA) was 0.30 logarithm of the minimum angle of resolution (logMAR) in each eye, the refraction in the right eye was plano -2.75 × 135 = 0.30 logMAR and in the left eye was -0.75 -2.50 × 45 = 0.18 logMAR. Twelve months postoperatively, there was recurrence of intense eye rubbing. UDVA dropped, and bilateral corneal steepening was noted. Bilateral corneal crosslinking was performed along with an allergist consultation for eye rubbing control. Ten years later, his UDVA was 1.3 logMAR and 0.40 logMAR and corrected distance visual acuity was 0.10 logMAR and 0.18 logMAR in the right and left eyes, respectively.
