Automated lamellar therapeutic keratoplasty for post-PRK corneal scarring and thinning

Am J Ophthalmol. 2004 Dec;138(6):1067-9. doi: 10.1016/j.ajo.2004.06.062.


Purpose: To present the use of automated lamellar therapeutic keratoplasty (ALTK) for the treatment of post-photorefractive keratectomy (PRK) corneal scarring and thinning with significant residual myopia.

Design: Interventional case report.

Methods: A patient with high myopia of -12 diopters previously underwent PRK that resulted in corneal scarring, myopic regression, moderate loss of best-corrected visual acuity, a residual refractive error of -6.50/-1.00 x 175 degrees, and a remaining corneal thickness of 300 mum. ALTK was first performed to remove the scar and to augment corneal thickness, and a subsequent laser-assisted in-situ keratomileusis (LASIK) procedure was performed to correct the residual myopia.

Results: ALTK effectively removed the corneal scar and augmented the corneal thickness to 639 mum. LASIK effectively treated the residual myopia, resulting in an unaided visual acuity of 20/25 and a stable refractive error of plano/-0.50 x 40 degrees. The ALTK interface remained clear throughout the follow-up period of 26 months.

Conclusion: ALTK may be a reasonable alternative to conventional penetrating keratoplasty in the treatment of post-PRK corneal scarring and thinning, with a moderate loss of best-corrected visual acuity, and LASIK can be subsequently performed to correct the residual refractive error and achieve an excellent refractive and visual outcome.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cicatrix / etiology
  • Cicatrix / surgery*
  • Cornea / pathology
  • Corneal Diseases / etiology
  • Corneal Diseases / surgery*
  • Corneal Transplantation / methods*
  • Humans
  • Lasers, Excimer
  • Male
  • Photorefractive Keratectomy*
  • Postoperative Complications / surgery*
  • Visual Acuity