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Case Reports
. 2022 Nov 30;34(3):352-356.
doi: 10.4103/joco.joco_342_21. eCollection 2022 Jul-Sep.

Topical Minoxidil Solution-Induced Central Toxic Keratopathy following Photorefractive Keratectomy: A Case Study

Mehrdad Mohammadpour  1 , Masoud Khorrami-Nejad  1 , Mohsen Heirani  1 , Majid Moshirfar  2   3   4
Affiliations
Case Reports

Topical Minoxidil Solution-Induced Central Toxic Keratopathy following Photorefractive Keratectomy: A Case Study

Mehrdad Mohammadpour et al. J Curr Ophthalmol. .

Abstract

Purpose: To report the clinical findings of unilateral central toxic keratopathy (CTK) associated with inadvertent exposure to topical minoxidil 5% solution 1 day after bilateral photorefractive keratectomy (PRK).

Methods: Anterior segment slit-lamp photography, anterior segment optical coherence tomography (AS-OCT), pachymetry map, epithelial map, and manifest refractions were recorded.

Results: This is a case of a 27-year-old male who underwent bilateral PRK and presented 5 days after surgery with the complaint of acute decreased visual acuity in the left eye (LE). His LE was reportedly exposed to topical ethanol-based minoxidil 5% on postoperative day 1, which he was using as a posthair transplant treatment. Clinical examination showed hyperopic shift, poor visual acuity, central corneal opacity, epithelial irregularity, central corneal thinning, and flattening on AS-OCT. These findings were consistent with a diagnosis of CTK. The patient was monitored with conservative treatment and demonstrated full recovery after 6 months.

Conclusion: It is recommended to warn patients who have undergone refractive surgery concerning the use of ethanol-containing agents, such as minoxidil solution, because of the possible risk of CTK, a complication not formally recognized.

Keywords: Anterior segment optical coherence tomography; Central toxic keratopathy; Photorefractive keratectomy.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Central corneal opacity on slit-lamp imaging of the left eye (a), and anterior segment optical coherence tomography, pachymetry map, and epithelial map (b) 5 days after photorefractive keratectomy surgery
Figure 2
Figure 2
Slit-lamp imaging (a), and anterior segment optical coherence tomography, pachymetry map, and epithelial map (b) 6 months following photorefractive keratectomy surgery
See this image and copyright information in PMC

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