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Case Study – Corneal Toxic Keratopathy (CTK)

Mr M A, a 45 year old managing director wanted to be free of spectacles and contact lenses. He has worn contact lenses for last 13 to 14 years but started having issues when swimming and travelling. He also began to notice changes to his near vision.

Initial Examination:

Corneal Toxic Keratopathy Case Study

Corneal Toxic Keratopathy Case Study 2

The consultation showed the patient to have healthy eyes, a straight forward myopic prescription, with a slight amount of astigmatism and early presbyopia, making him completely suitable for LASIK surgery.

Bilateral Wavefront Intralase LASIK was performed on 10.07.2015 without any complications.

Corneal Toxic Keratopathy Case Study 3

The patient was reviewed at day 2 due to the appearance of abnormal healing and possible DLK.

Corneal Toxic Keratopathy Case Study 4

At this stage it is difficult to know the correct diagnosis giving the appearance of the cornea.

Corneal Toxic Keratopathy

Corneal Toxic Keratopathy Case Study 5

This was not a normal case of DLK and therefore suspicious of bilateral Corneal Toxic Keratopathy (CTK). Further testing was carried out, including OCT and confocal microscopy.

oct

confocal microscopy

Corneal Toxic Keratopathy Case Study 6

Slit-lamp findings of the cornea indicated that it was clear with only a few striae.

Scans – Keratomatic

August 2015:

kerotamatic eye scans

August 2016

kerotamatic eye scans after treatment

The anterior corneal flattening was spontaneously resolved. The corneal appearance has greatly improved and almost back to normal.

Both the patient and surgeon are very happy.

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