Topography-guided transepithelial phototherapeutic keratectomy to treat a partial laser in situ keratomileusis flap amputation over the visual axis

We describe the use of topography-guided transepithelial phototherapeutic keratectomy (PTK) to restore excellent uncorrected distance visual acuity (UDVA) in an eye with extremely irregular topography as a result of a severe complication during laser in situ keratomileusis (LASIK) flap creation. Three months before the patient presented to our clinic, the microkeratome cut outward during LASIK flap creation, amputating the partially cut flap across the visual axis. Without a flap cut into the preserved one half of the cornea, complete flap amputation was not considered a safe option. Topography-guided transepithelial PTK was used to regularize the cornea and treat the resulting irregular astigmatism. Six months postoperatively, the cornea remained stable and the UDVA was 6/6+2.