2 separate RKs, then 4 separate Lasiks

The 2 photos below are of the right eye of a patient who underwent 2 separate Radial Keratotomy (RK) surgeries in the 1980’s followed by 4 separate LASIK surgeries years later. The 2nd photo was taken 3 years after the 1st photo was taken. In the first photo you can see blood vessels growing along the still open RK incisions. The white “hatchet” structure is epithelial ingrowth. These are cells from the corneal surface that got under the LASIK flap (where they do not belong) and began growing. In the 2nd photo, taken 12 months ago, note that the epithelial ingrowth has dissipated. Now the central cornea has a scratched ground glass appearance. 12 months ago, we referred this patient to a world renown eye institution where she was seen by several corneal specialists. A diagnosis of “crystalline keratopathy” was made and this patient was promptly placed on fortified antibiotics. The crystal formations seen here are deep within the cornea and not on the surface. This patient left our geographic area for a 10 month period and recently returned to see the corneal specialists at this institution. Yesterday I was informed that this patient’s cornea has the same appearance as it did last year and that she is still on antibiotic therapy. I was also told that collectively, these corneal specialists have never seen anything like this before. I will be seeing her next week for the first time in a year and am anxious to have a look at her eyes as I have sequential photos of her eyes that I have taken over a 9 year period. What puzzles me is why would a doctor or doctors do so many destructive operations on a single eye and why would this patient allow such outrageous behavior be inflicted on herself?

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