Klin Monbl Augenheilkd 2023; 240(06): 810-814
DOI: 10.1055/a-1922-4619
Der interessante Fall

Central Toxic Keratopathy after Small Incision Lenticule Extraction

Zentrale toxische Keratopathie nach Small Incision Lenticule Extraction (SMILE)
Mehmet Gülmez
1   Ophthalmology, Konya Dünya Göz Hospital, Konya, Turkey
,
Özlem Ural Fatihoglu
2   Ophthalmology, Manisa Akhisar State Hospital, Manisa, Turkey
› Author Affiliations

Introduction

Small incision lenticule extraction (SMILE) is a corneal refractive surgical procedure based on flapless extraction of the intrastromal lenticule created by a femtosecond laser. SMILE is comparable to femtosecond laser-assisted in situ keratomileuses (FS-LASIK) in terms of safety, efficacy, and predictability [1], [2]. Compared to FS-LASIK, it is known that it provides better ocular surface stability, is preferable in dry eyes, and affects corneal biomechanics less. Postoperative residual refractive error and visual acuity results are similar to FS-LASIK [3], [4]. It is increasingly preferred in the treatment of myopia and myopic astigmatism due to its sharp visual acuity and increased patient satisfaction.

Central toxic keratopathy (CTK) is a rare, self-limited, noninflammatory, post-refractive laser condition that presents with central corneal opacification and a significant hyperopic shift [5], [6], [7]. The cause of CTK is unknown, although it has been hypothesized that photoactivation of some substance, possibly povidone-iodine, by the laser induces keratocyte apoptosis and stromal necrosis [6].

The purpose of this article is to report a case of CTK after SMILE laser surgery. Written informed consent was obtained from the patient for this case report, as well as all the images herein, to be published.



Publication History

Received: 14 July 2022

Accepted: 08 August 2022

Accepted Manuscript online:
10 August 2022

Article published online:
29 September 2022

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