Phototherapeutic Keratectomy for Concrete-Induced Corneal Chemical Injury: A Case Report

TL;DR

This case report describes the first successful use of phototherapeutic keratectomy to treat a severe corneal injury caused by concrete exposure.

Contribution

The paper presents the first documented use of PTK for concrete-induced corneal chemical injury.

Findings

PTK improved visual acuity from 20/133 to 20/20 in a patient with concrete-induced corneal injury.

The excimer laser effectively removed embedded concrete particles without damaging surrounding tissue.

PTK may become a new standard for treating persistent corneal opacities from concrete injuries.

Abstract

Chemical injuries to the cornea, particularly those caused by alkaline substances like concrete, can lead to severe ocular damage and vision impairment. To the best of our knowledge, there are no published reports on the use of phototherapeutic keratectomy (PTK) specifically for concrete-induced corneal injuries. This case report presents the first documented successful management of a concrete-induced corneal chemical injury using PTK. A 69-year-old male patient presented with bilateral ocular injuries following exposure to concrete after a machine explosion at work. The right eye exhibited substantial damage, categorically designated as Grade 3b according to the Kinoshita classification system, manifesting as extensive limbal epithelial deficiency and the presence of concrete particles embedded within the corneal surface. Following an initial management plan that incorporated irrigation and anti-inflammatory therapy, on day 12 post-injury, the patient underwent PTK to address the superficial corneal opacification caused by concrete particles. Visual acuity exhibited a marked enhancement, progressing from 20/133 (uncorrected) preoperatively to 20/20 (with correction) postoperatively, accompanied by substantial clearance of the corneal opacity. This novel case demonstrates that phototherapy (PTK) is an effective treatment modality for corneal injuries caused by exposure to concrete, where superficial opacification and embedded particles pose a challenge to conventional management. The precise ablation capability of the excimer laser allows for targeted removal of concrete deposits without excessive damage to surrounding tissue, facilitating visual rehabilitation. This approach has the potential to establish a novel standard of care for the management of persistent corneal opacities resulting from concrete injuries.

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