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To describe a case of bilateral central toxic keratopathy (CTK) in a post–laser in situ keratomileusis–treated patient using tomographic methods for more than a 1-year follow-up.Case report and literature review.Tomographic analysis of a patient with bilateral CTK revealed flattening of the anterior cornea curvature and thinning at the level of anterior stromal bed, with minimal changes of the posterior curvature. A thin central flap was also noted on optical coherence tomography (OCT). Over the course of a year, the patient's hyperopic shift resolved with steepening of the anterior curvature and concomitant thickening of the flap and stromal bed.Using Scheimpflug imaging and Visante OCT, we demonstrated that the hyperopia that accompanies CTK is related to anterior corneal curvature changes. We also found that the majority of corneal tissue loss occurs at the anterior stromal bed mainly in the first postoperative week and is followed by a regeneration of tissue. A thin central flap was noted, and it is not clear whether this was created intraoperatively or resulted from the presence of CTK, requiring further study.