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Results: at 1 week, slit-lamp and OCT showed central corneal haziness, thinning, flattening, and hyperopic astigmatism consistent with CTK; conservative monitoring led to improvement by 6 months and stable outcomes through 2 years. Conclusions: CTK is vision-threatening and may occur after multiple refractive surgeries; accurate recognition aids differential diagnosis.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/central-toxic-keratopathy-after-photorefractive-keratectomy-two-year-follow-up-case-report-and-review-of-the-literature/417294/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/central-toxic-keratopathy-after-photorefractive-keratectomy-two-year-follow-up-case-report-and-review-of-the-literature/417294.png","ImageObject",300,407,{"name":42,"@type":43},"anakgang17","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-30","2026-09-28",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",9,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What was the clinical purpose of the report?","Question",{"text":63,"@type":64},"To document a rare case of central toxic keratopathy (CTK) developing after photorefractive keratectomy (PRK) and to review relevant literature.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How was CTK identified in the postoperative period?",{"text":68,"@type":64},"At 1 week after surgery, slit-lamp findings and optical coherence tomography (OCT) demonstrated central corneal haziness, thinning, flattening, and hyperopic astigmatism consistent with CTK.",{"name":70,"@type":61,"acceptedAnswer":71},"What outcome did the patient achieve during the two-year follow-up?",{"text":72,"@type":64},"By 6 months, hyperopia decreased and best-corrected visual acuity reached 20/20; over the next 2 years, refraction and corneal thickness remained stable with no further significant changes.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},417294,1790718927,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":33,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":123,"preview_page_count":4},962090883568,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","| Case Report |\n| --- |\n|  |\n\nCentral Toxic Keratopathy after Photorefractive Keratectomy: Two-Year Follow-Up Case Report and Review of the Literature  \nJavad Sadeghi1, Negareh Yazdani2, Mohammad-Reza Sedaghat1, Iman Varshovi-Jaghargh2  \n1Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran, 2Department of Optometry, School of Paramedical and Rehabilitation Sciences,  \nMashhad University of Medical Sciences, Mashhad, Iran  \nAbstract  \nPurpose: To report a rare case of central toxic keratopathy (CTK) after photorefractive keratectomy (PRK) .  \nMethods: A 22-year-old male underwent bilateral PRK for the correction of myopic astigmatism. Preoperative refraction measurements were −2.50 −1.00 × 65 in the right eye and −3.50 diopter (D) sphere in the left eye. The intended refractive correction was −3.25 −1.00 × 65 (in the right eye) and −4.25 D sphere in the left eye. Preoperative corneal thickness measured 489 μm (in the right eye) and 491 μm in the left eye, both values exceeding the minimum safe threshold for PRK.  \nResults: At the 1-week postoperative evaluation, slit-lamp examination and optical coherence tomography (OCT) revealed significant central corneal haziness, thinning, and flattening, along with hyperopic astigmatism. These findings were consistent with CTK. The surgeon adopted a conservative approach, closely monitoring the patient without initiating pharmacological intervention. By the 6-month follow-up, the patient demonstrated reduced hyperopia and achieved a best-corrected visual acuity of 20/20. OCT imaging also confirmed increased central cornealand epithelial thickness, suggesting progressive recovery. Long-term follow-up over 2 years showed stable refraction and corneal thickness, with no further significant changes.  \nConclusions: CTK is a rare but vision-threatening complication of refractive surgery, occurring not only after laser in situ keratomileusis but also following other refractive surgery approaches. Enhancing clinical knowledge of both its presentation and differential diagnosis is essential to avoid any unnecessary interventions.  \nKeywords: Central toxic keratopathy, Optical coherence tomography, Photorefractive keratectomy, Refractive surgery  \nAddress for correspondence: Iman Varshovi‑Jaghargh, Department of Optometry, Mashhad University of Medical Sciences, Mashhad, Iran.  \nE‑mail: [I.Varshovi@Gmail.com](I.Varshovi@Gmail.com)  \nSubmitted: 30‑Apr‑2025; Revised: 01‑Aug‑2025; Accepted: 01‑Aug‑2025; Published: 19‑Dec‑2025  \nIntroductIon  \nRefractive surgery has become a widely preferred method for vision correction worldwide, with an estimated 20–25 million procedures performed over the past 25 years.1 Today, multiple surgical approaches have been introduced for refraction correction, such as radial keratotomy, photorefractive keratectomy (PRK), laser in situ keratomileusis (LASIK), and small incision lenticule extraction.2 PRK is one of the laser-based surgeries which correct refractive error through removing epithelium tissue and ablating stroma.3,4 A study by  \n\n| Access this article online |  |\n| --- | --- |\n| Quick Response Code:\u003Cbr>| Website:\u003Cbr>[https://journals.lww.com/joco](https://journals.lww.com/joco) |\n|  | DOI:\u003Cbr>10.4103/joco.joco_ 125_25 |\n\nJoffe demonstrated that PRK comprised approximately 15% of all refractive surgical procedures performed. This means that roughly 140,438 PRK surgeries were carried out each year.1 The most observed complications following PRK include over/ undercorrection, refractive regression, corneal haze, cornealectasia, and dry eye.5 Central toxic keratopathy (CTK) is a rare complication that occurs in 0.016% of the subjects who underwent PRK.6 The main clinical features of CTK are an acute onset accompanied with noninflammatory, painless, and  \nThis is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License (CC BY-NC-ND), where it is permissible to download and sh","cbCaikFGokBgKqS2","https://ap.wps.com/l/cbCaikFGokBgKqS2","pdf",845956,"English","# Abstract\n## Purpose\n## Methods\n## Results\n## Conclusions\n# Introduction\n# Case report and follow-up\n# Discussion and literature review","[{\"question\":\"What was the clinical purpose of the report?\",\"answer\":\"To document a rare case of central toxic keratopathy (CTK) developing after photorefractive keratectomy (PRK) and to review relevant literature.\"},{\"question\":\"How was CTK identified in the postoperative period?\",\"answer\":\"At 1 week after surgery, slit-lamp findings and optical coherence tomography (OCT) demonstrated central corneal haziness, thinning, flattening, and hyperopic astigmatism consistent with CTK.\"},{\"question\":\"What outcome did the patient achieve during the two-year follow-up?\",\"answer\":\"By 6 months, hyperopia decreased and best-corrected visual acuity reached 20/20; over the next 2 years, refraction and corneal thickness remained stable with no further significant changes.\"}]","Central Toxic Keratopathy after Photorefractive Keratectomy - Two-Year Follow-Up Case Report and Review of the Literature | PDF",1790608739]