Corneal perforation during laer in itu keratomileui after hyperopic electrothermal keratoplaty

Purpoe To report a corneal perforation during laer in itu keratomileui (LAIK) after previou electrothermokeratoplaty. Deign Interventional cae report. Method A 49-year-old man preented with primary hyperopia in the right eye and reidual hyperopia after electrothermokeratoplaty in the left eye. Hi refraction wa +4.00 in the right eye and +7.00 −3.00 × 135 degree in the left eye, with a central pachymetry of 535 μm and 549 μm, repectively. Phacoemulification with intraocular len (IOL) inertion in the right eye and a two-tep keratophacorefractive procedure with a piggyback IOL inertion and LAIK in the left eye were propoed. Reult Potoperative refraction wa −0.50 −0.50 × 150 degree 20/20 in the right eye. Potphacoemulifi-cation refraction wa −4.75 −4.25 × 135 degree in the left eye. Laer in itu keratomileui wa performed in the left eye, 4 month later, with uneventful atigmatic laer ablation. During the myopic ablation, a udden outcome of aqueou humor in one of the temporal corneal car wa oberved. Concluion Unpredictably thin area after electrothermokeratoplaty may lead to unexpected corneal perforation during LAIK. The available pachymetry ytem may be unreliable after electrothermal keratoplaty.