3 RKs followed by 3 Lasiks

These 3 images are of the same eye. This eye underwent 3 separate RK surgeries in the 1980’s followed by 3 separate LASIK procedures between 25 and 30 years later. The first photo was taken 5 years ago. Note the open RK incisions and the blood vessel growth along the RK incisions. The milky-white hatchet shaped structure close to the pupil is epithelial ingrowth which are epithelial cells found in the outer layer of the cornea which got under the LASIK flap. 5 years ago this patient was referred to a corneal surgeon at major eye institution to see if he could life the LASIK flap and clean out the debris that got under the flap. This doctor was fearful of doing this because he felt that there was an unacceptable risk that the patient would need a corneal transplant on this eye. 6 months ago I took another photo of the same eye. Note the white “flecks” in the center of the cornea. Again, the patient was referred to the corneal specialists at this same major teaching eye institution who diagnosed this eye with a very rare condition known as “infectious crystalline keratopathy.” The last image was taken with a technology known as “optical coherence tomography.” Here you see a cross sectional image of the same eye with a scleral lens over it. Note that these crystalline deposits reside in the center of the cornea. Infectious crystalline keratopathy is one of the risk factors for refractive eye surgeries such as RK and LASIK which may appear many years later.