Tillmann, Anne; DanielKampik, Daniel; Borrelli, Maria; Seidl, Maximilian; Menzel-Severing, Johannes; Seiler, Theo Günter; Geerling, Gerd (2022). Acute corneal melt and perforation - A possible complication after riboflavin/UV-A crosslinking (CXL) in keratoconus. American journal of ophthalmology case reports, 28, p. 101705. Elsevier 10.1016/j.ajoc.2022.101705
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Purpose
To report two cases of acute corneal melting and perforation requiring emergency penetrating keratoplasty after corneal crosslinking (CXL) in advanced keratoconus.
Observations
Case 1 was a 34 and case 2 was a 16-year old male, both with progressive keratoconus, who underwent CXL (Dresden protocol). After riboflavin imbibition, patients had a minimal pachymetry of 337 μm and 347 μm, and therefore required stromal swelling by hypoosmolar riboflavin resulting in pachymetries of 470 μm and 422 μm, prior to the 30 minute UV-irradiation with 3mW/cm2. In case 1, on the 7th postoperative day a 4mm linear perforation occurred. Extensive post-hoc examinations revealed no infectious cause. In case 2, a corneal melting developed within 24 hours, from which Staphylococcus aureus was cultured.
Conclusions and importance
Acute corneal melting and perforation may occur after CXL. Dysfunctional collagen metabolism, atopia, thin preoperative pachymetry and the use of hypoosmolar substances may have initiated this complication in our cases.
Item Type: |
Journal Article (Further Contribution) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ophthalmology |
UniBE Contributor: |
Seiler, Günter Theodor Michael |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2451-9936 |
Publisher: |
Elsevier |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
04 Oct 2022 15:26 |
Last Modified: |
05 Dec 2022 16:25 |
Publisher DOI: |
10.1016/j.ajoc.2022.101705 |
PubMed ID: |
36187442 |
Uncontrolled Keywords: |
CXL Complication Corneal perforation Crosslinking Keratoconus Penetrating keratoplasty |
BORIS DOI: |
10.48350/173471 |
URI: |
https://boris.unibe.ch/id/eprint/173471 |
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