Purpose: We report a case of transient corneal opacity and hyperopia after LASEK surgery. Case summary: A 21-year-old female visited our clinic complaining of decreased visual acuity in the left eye. The patient had undergone LASEK surgeryten days previously. Before LASEK surgery, the central corneal thickness of the left eye was 540 μm, and the refractive error was -2.00 Dsph=-0.75 Dcyl ×80A with an estimated ablation depth of 52.2 μm. At the time of visit (on the tenth day after surgery), the best corrected visual acuity (BCVA) was 0.07, the central corneal thickness was 404 μm, and the refractive error was +1.00D=+1.25D ×90. Slit-lamp biomicroscopy showed round central corneal haziness, but there were no signs of inflammation. At the third weeks after surgery, the central corneal thickness was 401 μm and the refractive error was +11.25D=-4.00D ×145. Slit-lamp biomicroscopy showed sustained round central corneal haze. Twenty-two weeks after surgery, the central corneal thickness was 445 μm and the refractive error was -0.75D=-1.25D ×180. The corneal opacity had disappeared.Conclusions: In case of transient corneal opacity, stromal loss and hyperopic change after LASEK surgery, central toxic keratopathy should be considered. J Korean Ophthalmol Soc 2010;51(5):769-773