Central Toxic Keratopathy in Siblings After Laser-Assisted Keratomileusis: Case Report and Literature Review

Abstract

The purpose of this study was to report an isolated case of 2 siblings who developed central toxic keratopathy (CTK) after undergoing laser-assisted keratomileusis (LASIK) on the same day.Methods: This was a case report and literature review.

Acute central corneal haze and thinning with atypical keratitis presentation

“…In 2022, I published a case report describing an isolated case of laser in situ keratomileusis (LASIK)-induced CTK in a pair of siblings from different households who underwent surgery the same day without any other affected cases seen. 5 It would not be unreasonable to presume that some individuals may be more susceptible to developing CTK based on the genetic makeup of their own tear film composition and meibomian gland secretions, which contain combinations of bacteria, inflammatory cells, matrix metalloproteinases, and other proteolytic enzymes that can trigger CTK. Differential gene expression has also been found in the mucin tear layer in humans and in mouse models on corneal wound healing, which may also explain why the severity of CTK presentation can vary so widely within the same outbreak.…”

“…Differential gene expression has also been found in the mucin tear layer in humans and in mouse models on corneal wound healing, which may also explain why the severity of CTK presentation can vary so widely within the same outbreak. 5…”

“…There have been reports of central toxic keratopathy in siblings after LASIK. 1,2 There are also reports of atypical presentation of AK resembling central toxic keratopathy. 3 My diagnosis would be AK, and for diagnostic purposes, I would also perform confocal microscopy and cultures, as were performed by the treating physicians.…”