Central Toxic Keratopathy after Small Incision Lenticule：a case report

Objective To report a case of central toxic keratopathy (CTK) occurring after small incision lenticule extraction (SMILE) in a monocular patient, with an 18-month follow-up. Methods The patient’s postoperative condition was monitored through visual acuity tests, slit-lamp examinations, refraction assessments, anterior segment photography, and corneal topography. Results On postoperative day 1, the patient developed diffuse lamellar keratitis (DLK). By postoperative week 1, CTK manifested as central corneal opacity, corneal thinning, hyperopic shift, and decreased visual acuity. After 18 months of follow-up, the patient exhibited favorable recovery. Conclusion CTK is a rare, self-limiting complication of corneal refractive surgery characterized by non-inflammatory central corneal opacity, corneal thinning, and significant hyperopic shift. It is unresponsive to corticosteroid therapy.