# Advanced Surface Ablation in a Patient With Suspect Topography: A Case Report

## TL;DR

A patient with a suspected eye condition successfully underwent laser eye surgery after a decade-long follow-up.

## Contribution

This case report highlights PRK as a viable option for patients with atypical corneal topography or mild keratoconus.

## Key findings

- Advanced surface ablation with PRK was successfully performed on a patient previously misdiagnosed with keratoconus.
- Long-term follow-up showed positive outcomes, emphasizing the importance of accurate preoperative imaging.
- PRK may be suitable for patients with atypical corneal topography or mild forms of corneal ectasia.

## Abstract

The purpose of this clinical report is to describe a 10-year clinical outcome of advanced surface ablation with photorefractive keratectomy (PRK) in a patient who had been previously incorrectly diagnosed with keratoconus (KC). Corneal ectasia is a rare but extremely relevant complication of laser vision correction, and KC represents a major contraindication for these procedures. Nonetheless, some surface ablation procedures, such as PRK, might be a valid option for particular patients with atypical corneal topography or subclinical or mild forms of KC. Patient education and complete preoperative refractive multimodal imaging are essential for a more conscious therapeutic decision, minimizing iatrogenic ectasia, as well as decreasing the number of patients who are incorrectly denied refractive surgery, as was the patient presented in this study.