Is PRK retreatment after LASIK as safe as expected: case report

Introduction: A case of traumatic epitheliostromal erosion after photorefractive keratectomy (PRK) retreatment after laser in situ keratomileusis (LASIK) is reported, highlighting the challenges of managing multiple coexistent refractive surgical complications. Patient and Clinical Findings: A 30-year-old man developed a traumatic epitheliostromal erosion 10 years after PRK retreatment after LASIK presenting multiple complications that posed a therapeutic dilemma. Diagnosis, Intervention, and Outcomes: Owing to persistent corneal haze and epithelial ingrowth, diagnosed clinically and on optical coherence tomography (OCT), and unresponsive to prolonged corticosteroid treatment, transphototherapeutic keratectomy (PTK) with 0.02% mitomycin-C was performed. On follow-up visits, the patient's corrected distance visual acuity improved to 20/15, with clear central cornea and minimal residual peripheral haze. Corneal OCT showed stable central corneal thickness and reduced epithelial thickness as well as stromal irregularities. Conclusions: PRK retreatment after LASIK can pose challenges, making careful risk assessment and advanced management techniques essential for achieving optimal results in complex refractive surgery retreatments. In this case, transPTK successfully treated epithelial ingrowth and corneal haze, improving visual outcomes.