Pressure-Induced Stromal Keratopathy after Surface Ablation Surgery.

Bibliographic Details
Title:	Pressure-Induced Stromal Keratopathy after Surface Ablation Surgery.
Authors:	Guedes, Jaime¹ (AUTHOR), Vilares-Morgado, Rodrigo^1,2 (AUTHOR) vilaresmorgador@gmail.com, Brazuna, Rodrigo^1,3 (AUTHOR), Costa Neto, Alexandre^1,3 (AUTHOR), Mora-Paez, Denisse Josefina¹ (AUTHOR), Salomão, Marcella Q.¹ (AUTHOR), Faria-Correia, Fernando^1,4 (AUTHOR), Ambrósio Jr., Renato^1,3,5 (AUTHOR)
Source:	Case Reports in Ophthalmology. Jul2024, Vol. 15 Issue 1, p532-541. 10p. 6 Illustrations.
Subject Terms:	TONOMETRY, PHOTOREFRACTIVE keratectomy, SLIT lamp microscopy, CORNEAL opacity, INTRAOCULAR pressure, CORNEA, ORAL drug administration, LASIK
Abstract:	Introduction: The purpose of this clinical report was to describe an unprecedented case of bilateral pressure-induced stromal keratopathy (PISK) following corneal photorefractive keratectomy, associated with presumed herpetic keratitis, and to present tomographic and biomechanical findings before and after appropriate treatment. Case Presentation: A 33-year-old male patient was referred to our clinic with suspected delayed corneal epithelial healing 3 weeks after an uncomplicated PRK. A central layer of corneal opacity with a presumed fluid-filled interface area was observed upon slit lamp biomicroscopy. Scheimpflug images from the Pentacam® revealed a hyperreflective area beneath the central cornea. Scheimpflug-based corneal tomography, biomechanical assessment using the Pentacam® AXL Wave, and the Corvis ST® were conducted. Goldmann applanation tonometry measured 23/13 mm Hg, while noncontact tonometry intraocular pressure measured with the Corvis ST® (Corvis ST IOPnct) was 40.5/43.5 mm Hg. Treatment with oral valacyclovir, combined with ocular hypotensive therapy, led to a significant reduction in IOP and improved corneal deformation parameters after 1 month. Conclusion: Surgeons should be aware of the inaccuracy of Goldmann applanation tonometry in PISK, which can occur after LASIK or surface ablation. [ABSTRACT FROM AUTHOR]
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