Central toxic keratopathy after laser in situ keratomileusis

J Cataract Refract Surg. 2014 Dec;40(12):1985-93. doi: 10.1016/j.jcrs.2014.03.030. Epub 2014 Nov 24.


Purpose: To review cases of central toxic keratopathy (CTK) occurring over a period of 46 days.

Setting: Moorfields Eye Hospital, London, United Kingdom.

Design: Retrospective consecutive case series.

Methods: This was a review of patients with CTK after uneventful laser in situ keratomileusis (LASIK) performed by 1 of 5 surgeons at a single institute. The following parameters were analyzed: corrected distance visual acuity (CDVA), manifest refraction, and central corneal thickness from Scheimpflug pachymetry readings (Pentacam).

Results: The cohort consisted of 15 eyes of 9 patients. Thirteen eyes were diagnosed within 7 days after LASIK, while the remaining 2 eyes developed CTK 12 days postoperatively. In 10 eyes, the time to resolution was 1 to 8 months. Five eyes still had residual signs at the last outpatient visit. At the final follow-up, 3 eyes (20%) had a CDVA worse than 0.0 logMAR.

Conclusions: Although a rare entity, CTK can occur in clusters. Although a cause was not fully isolated, ultimately each eye achieved excellent CDVA (all better than 0.2 logMAR) at the last follow-up.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Androstadienes / therapeutic use
  • Anti-Allergic Agents / therapeutic use
  • Corneal Stroma / pathology*
  • Corneal Topography
  • Humans
  • Hyperopia / surgery
  • Keratitis / diagnosis
  • Keratitis / drug therapy
  • Keratitis / etiology*
  • Keratomileusis, Laser In Situ / methods*
  • Lasers, Excimer / therapeutic use*
  • Loteprednol Etabonate
  • Male
  • Microscopy, Confocal
  • Myopia / surgery
  • Postoperative Complications*
  • Refraction, Ocular / physiology
  • Retrospective Studies
  • Surgical Flaps / pathology*
  • Visual Acuity / physiology


  • Androstadienes
  • Anti-Allergic Agents
  • Loteprednol Etabonate