Late onset of a persistent, deep stromal scarring after PRK and corneal cross-linking in a patient with forme fruste keratoconus.
OBJECTIVE
To present a case of a late, deep stromal scar in a 22-year-old patient with forme fruste keratoconus who underwent combined corneal cross-linking and photorefractive keratectomy (PRK).


METHODS
Topography-guided corneal cross-linking combined with corneal PRK (without complications) was performed in both eyes with a delay of 2 weeks between each eye.


RESULTS
At the 5-month postoperative examination of the right eye, a localized corneal haze was circumscribed to the posterior deep stroma, signifying a decrease of visual acuity. However, this improved partially and temporarily when treated with topical corticoids during 2 years of follow-up and then reoccurred, affecting the corrected distance visual acuity.


CONCLUSIONS
To the authors' knowledge, this is the first documented, clinical case presenting a deep stromal affectation without endothelial decompensation and visual acuity affectation as a postoperative complication following topography-guided PRK and corneal cross-linking.
Jose L
JL
Güell
Paula
P
Verdaguer
Daniel
D
Elies
Oscar
O
Gris
Felicidad
F
Manero
D002921:Cicatrix / Q000175:diagnosis / Q000209:etiology*; D003094:Collagen / Q000378:metabolism; D003131:Combined Modality Therapy; D003316:Corneal Diseases / Q000175:diagnosis / Q000209:etiology*; D003319:Corneal Stroma / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D019781:Corneal Topography; D003432:Cross-Linking Reagents / Q000627:therapeutic use*; D006801:Humans; D007640:Keratoconus / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D008297:Male; D018903:Photorefractive Keratectomy; D017319:Photosensitizing Agents / Q000627:therapeutic use; D011183:Postoperative Complications; D012256:Riboflavin / Q000627:therapeutic use; D014466:Ultraviolet Rays; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin