title: Topography-guided (NIDEK customized aspheric treatment zone) photorefractive keratectomy with mitomycin C after penetrating keratoplasty for keratoconus: case report.
abstract: To report topography-guided photorefractive keratectomy (PRK) with mitomycin C (MMC) after penetrating keratoplasty for keratoconus.
  
  
  
  A 34-year-old woman with irregular astigmatism after penetrating keratoplasty in the right eye underwent PRK. Topography-guided surface ablation using the customized aspheric treatment zone ablation (CATz) was programmed for a 5.00-mm optical zone and an 8.50-mm transition zone. Mitomycin C was applied to corneal stroma for 20 seconds immediately after excimer laser ablation.
  
  
  
  Two months after surgery, the patient was very satisfied with the refractive outcome. Best spectacle-corrected visual acuity was 20/20 with a manifest refraction of -0.50 diopters. No haze formation was detected at 6-month follow-up. A significant improvement in the central 3 mm of the axial topography was noted.
  
  
  
  Topography-guided ablation using MMC may be a reasonable alternative for the management of refractive error after penetrating keratoplasty.
authors.affiliation: Department of Ophthalmology, University of São Paulo, São Paulo, Brazil. jackbr@terra.com.br
authors.forename: Jackson
authors.initials: J
authors.lastname: Barreto
authors.forename: Marcelo V
authors.initials: MV
authors.lastname: Netto
authors.forename: Alexandre
authors.initials: A
authors.lastname: Reis
authors.forename: Mayumi
authors.initials: M
authors.lastname: Nakano
authors.forename: Milton Ruiz
authors.initials: MR
authors.lastname: Alves
authors.forename: Samir Jacob
authors.initials: SJ
authors.lastname: Bechara
mesh_terms: D000328:Adult; D000477:Alkylating Agents / Q000008:administration & dosage*; D001251:Astigmatism / Q000188:drug therapy / Q000209:etiology / Q000601:surgery / Q000628:therapy; D003131:Combined Modality Therapy; D019781:Corneal Topography; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000601:surgery*; D015948:Keratoplasty, Penetrating / Q000009:adverse effects*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D016685:Mitomycin / Q000008:administration & dosage*; D009216:Myopia / Q000188:drug therapy / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D018903:Photorefractive Keratectomy; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000477:Alkylating Agents; D016685:Mitomycin