Xiao Xiaoting, Li Xin, Zheng Liangding
FuZhou Eye Hospital, No. 88 Liuyi South Road, Cangshan District, Fuzhou City, Fujian Province, China.
School of Medicine, Xiamen Eye Center and Eye Institute of Xiamen University, Xiamen, China.
BMC Ophthalmol. 2025 Apr 9;25(1):192. doi: 10.1186/s12886-025-04016-9.
CTK is a rare, acute, noninflammatory, self-limiting corneal condition that occurs after refractive surgery and is characterized by dense central stromal opacification. Clinical hallmarks include significant central corneal haze, stromal thinning, Descemet's membrane folds, and a significant hyperopic shift within 3-9 days postoperatively. We reported a case of CTK occurring 5 years after refractive surgery.
A myopic patient who underwent Femtosecond Laser-Assisted In Situ Keratomileusis (FS-LASIK) five years prior presented with pain and blurred vision after rubbing his right eye. Initially, diagnosed with Stage III diffuse lamellar keratitis (DLK), the patient was treated with topical corticosteroids (prednisolone acetate and fluorometholone), antibiotics (tobramycin), intravenous vitamin C, and corneal lesion debridement. After treatment, the patient's vision improved. The diagnosis was later revised to corneal toxic keratopathy (CTK).
Early and correct differentiation between CTK and DLK could lead to a good prognosis. Corneal confocal microscopy is helpful in diagnosis. A reduction in the use of corticosteroids and antibiotics led to further ocular amelioration. Moreover, this treatment should actively promote corneal epithelial repair, and in the future, the use of vitamin C in the early stage of the disease can be considered.
角膜毒性病变（CTK）是一种罕见的、急性、非炎性、自限性的角膜疾病，发生于屈光手术后，其特征为中央基质致密混浊。临床特征包括显著的中央角膜混浊、基质变薄、Descemet膜褶皱以及术后3 - 9天内显著的远视性移位。我们报告了一例屈光手术后5年发生CTK的病例。
一名5年前接受飞秒激光原位角膜磨镶术（FS - LASIK）的近视患者，在揉右眼后出现疼痛和视力模糊。最初诊断为III期弥漫性板层角膜炎（DLK），患者接受了局部皮质类固醇（醋酸泼尼松龙和氟米龙）、抗生素（妥布霉素）、静脉注射维生素C以及角膜病变清创治疗。治疗后，患者视力改善。后来诊断修订为角膜毒性病变（CTK）。
早期正确区分CTK和DLK可带来良好预后。角膜共焦显微镜有助于诊断。减少皮质类固醇和抗生素的使用可使眼部进一步改善。此外，这种治疗应积极促进角膜上皮修复，未来在疾病早期可考虑使用维生素C。
