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Consultation section

Refractive Surgical Problem

May consultation #1

Yoo, Sonia H. MD

Journal of Cataract & Refractive Surgery: May 2010 - Volume 36 - Issue 5 - p 867
doi: 10.1016/j.jcrs.2010.03.003
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A 24-year-old woman presents for consultation for poor quality of vision in the right eye. She has a history of anterior stromal micropuncture performed 1/2 year ago and phototherapeutic keratectomy (PTK) 8 months ago for the treatment of recurrent epithelial erosions. The patient does not have a history of trauma to the right eye.

The ophthalmologic examination shows uncorrected distance visual acuity (UDVA) of 20/300 in the right eye and 20/30 in the left eye and a corrected distance visual acuity (CDVA) (spectacle) of 20/100 and 20/20, respectively. The manifest refraction is +3.50 +0.50 × 85 in the right eye and −0.75 +0.25 × 100 in the left eye, with no improvement on pinhole testing. The slitlamp examination shows grade 3 corneal subepithelial haze consistent with the previous PTK in the right eye. Evaluation of the posterior segment and intraocular pressure are normal in both eyes. The central corneal thickness is 472 μm in the right eye and 520 μm in the left eye. A slitlamp photograph is shown in Figure 1 and corneal topography in Figure 2.

Figure 1
Figure 1:
Slitlamp photograph, right eye.
Figure 2
Figure 2:
Corneal topography, right eye.

How would you treat this patient?

© 2010 by Lippincott Williams & Wilkins, Inc.