Recurrent subepithelial corneal opacities after excimer laser phototherapeutic keratectomy

Purpose. To report the recurrence of presumed post-viral conjunctivitis subepithelial corneal opacities after excimer laser phototherapeutic keratectomy (PTK). Method. Case report. Results. A 33-year-old ophthalmic technician developed recurrence of opacities after treatment of presumed post-viral keratitis subepithelial corneal opacities with the excimer laser. Conclusions. Post-viral keratitis subepithelial corneal opacities may recur after removal by excimer laser PTK. Recurrence of these opacities in anterior corneal stroma previously unaffected by opacities before laser treatment suggests the presence of viral antigen in deeper corneal tissue than that occupied by the original subepithelial opacities. The recurrence also suggests likely routes of corneal antibody penetration in the formation of these opacities. Intensive topical steroid treatment may play a role by increasing the depth of viral particle penetration into corneal stroma.