Anterior Segment Optical Coherence Tomography for Transepithelial Phototherapeutic Keratectomy in Central Corneal Stromal Scarring

PURPOSE: To demonstrate the use of anterior segment optical coherence tomography (ASOCT) in planning phototherapeutic keratectomy (PTK) removal of central corneal stromal scarring. METHODS: A 62-year-old male presented with central corneal scars associated with significant ocular surface disease. Videokeratographies obtained using 3 different systems were not reliable. ASOCT, however, provided consistent pachymetry in the presence of noncalcific stromal opacity, which extended below Bowman membrane. PTK was performed with a transepithelial ablation, mitomycin C (MMC), and a slightly myopic photorefractive keratectomy. RESULTS: Slit-lamp examination and postoperative ASOCT revealed an optically clear cornea with no evidence of stromal haze at any time point. CONCLUSION: Transepithelial PTK guided by ASOCT can allow for the precise and accurate removal of central corneal stromal opacities, resulting in a favorable refractive outcome.