Deep stromal opacity after corneal cross-linking.

Abstract

PURPOSE:

To describe 3 cases with deep corneal stromal opacity that occurred several months after corneal cross-linking.

METHODS:

A 36-year-old man, a 19-year-old man, and a 14-year-old girl underwent corneal cross-linking for their progressive keratoconus. Corneal cross-linking was performed according to the Dresden protocol. The corneal epithelium was ablated using an excimer laser in 2 cases and manually in 1 case. After 30 minutes of riboflavin presoaking, hypotonic riboflavin solution was applied until the corneal stroma swelled, after which the eyes were exposed to ultraviolet irradiation. Slit-lamp microscopy findings, uncorrected visual acuity, best-corrected visual acuity, manifest refraction, intraocular pressure, and corneal endothelial cell counts were evaluated, and corneal topography with Scheimpflug imaging was performed.

RESULTS:

In all cases, the epithelium healed without delay. All eyes showed mild stromal infiltration a few days after the procedure; however, the inflammation was resolved within 1 week. The corneal stroma revealed no opacity up to 1 month after the procedure. A deep stromal opacity that extended to the inferior paracentral area developed after a few months and remained for 6 months to 1 year. Because the opacity was not on the visual axis, the visual acuity was not involved.

CONCLUSIONS:

Deep stromal opacity developed several months after uneventful corneal cross-linking. Postoperative inflammation may play a crucial role in its pathogenesis.

• Authors: Naoko Kato, Kenji Konomi, Megumi Saiki, Kazuno Negishi, Masaru Takeuchi, Jun Shimazaki, Kazuo Tsubota
• Journal: Cornea (Cornea) Vol. 32 Issue 7 Pg. 895-8 (Jul 2013) ISSN: 1536-4798 [Electronic] United States
• PMID: 23407323 (Publication Type: Case Reports, Journal Article)

Chemical References

• Cross-Linking Reagents
• Photosensitizing Agents
• Collagen
• Riboflavin

Topics

• Adolescent
• Adult
• Cell Count
• Collagen (metabolism)
• Combined Modality Therapy
• Corneal Opacity (etiology, physiopathology, therapy)
• Corneal Stroma (metabolism, pathology)
• Corneal Topography
• Cross-Linking Reagents (therapeutic use)
• Endothelium, Corneal (pathology)
• Female
• Humans
• Intraocular Pressure (physiology)
• Keratoconus (drug therapy)
• Male
• Photosensitizing Agents (therapeutic use)
• Postoperative Complications
• Refraction, Ocular (physiology)
• Riboflavin (therapeutic use)
• Visual Acuity (physiology)
• Young Adult