Lasik over RK, then Cystalline Keratopathy

The 2 images below are of the same eye that underwent both Radial Keratotomy and LASIK surgery. I have been taking care of this patient for over 10 years. 2 years ago this opacity appeared in the center of one eye. I referred this patient to a major eye institution where a diagnosis of “Crystalline Keratopathy” was made. This condition is a very rare LASIK complication. This patient was prescribed fortified antibiotics to use over a year. Over the past year this opacity has become more pronounced. This week this patient visited a corneal specialist at another world class eye facility where a recommendation of removal the LASIK flap was recommended. The purpose of this procedure is to culture the tissue to determine what organism (bacteria, fungus etc.) has caused this opacity to occur. Today this patient and I went back and forth texting each other. She told me that this lesion was thickening and the visual haze was more severe. She also wrote ” if left untreated it can literally explode in bacteria creating a much worse condition….” ” ultimately I will likely need a corneal transplant”. she continued ” I am at the end of my rope”. The first photo was taken 2 years ago. You can see that the opacity is in the line of vision. The 2nd image was taken with a technology known as “optical coherence tomography”. This image was also taken 2 years ago. The curved thick grey structure is the cornea. The white streak going through the center of the cornea are the crystalline formations.