Related Experiment Video
Updated: Jun 23, 2026
Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis
Published on: November 12, 2015
Polymicrobial keratitis after a collagen cross-linking procedure with postoperative use of a contact lens: a case
Katherine V Zamora1, John J Males
1Corneal Unit, Sydney Eye Hospital, New South Wales, Australia.
Purpose:
: To report a case of polymicrobial keratitis caused by Streptococcus salivarius, Streptococcus oralis, and coagulase-negative Staphylococcus sp. in a patient who underwent collagen cross-linking for keratoconus.
Method:
: Case report.
Result:
: A 32-year-old male presented with a 1-day history of a painful red eye, occurring 3 days after he had undergone a collagen cross-linking with riboflavin and UV-A on his left eye for keratoconus. He admitted to removing his bandage contact lens and cleaning it in his mouth before reapplying it in his eye. On presentation, a severe keratitis with an 8-mm epithelial defect and 360-degree ring infiltrate was found. Culture results from his contact lens were positive for S. salivarius and S. oralis, and coagulase-negative Staphylococcus sp. were grown from his corneal scrapings.
Conclusions:
: Collagen cross-linking is a promising procedure for the treatment of progressive keratoconus with minimal reported side effects. However, the possibility of a secondary infection after the procedure exists because the patient is subjected to epithelial debridement and the application of a soft contact lens. The role of the UV light on the immune mechanisms of the cornea and its effect on corneal wound healing warrant further investigation.
Insights
A patient developed polymicrobial keratitis after collagen cross-linking for keratoconus, highlighting infection risks. Proper contact lens hygiene is crucial post-procedure to prevent serious eye infections.
Area of Science:
- Ophthalmology
- Microbiology
Background:
- Collagen cross-linking (CXL) is an effective treatment for progressive keratoconus.
- The procedure involves epithelial debridement and bandage contact lens use, posing potential infection risks.
Observation:
- A 32-year-old male presented with severe keratitis and a ring infiltrate three days after CXL.
- The patient reported improper cleaning of his bandage contact lens.
- Cultures revealed polymicrobial infection with Streptococcus species and coagulase-negative Staphylococcus.
Findings:
- Polymicrobial keratitis caused by Streptococcus salivarius, Streptococcus oralis, and coagulase-negative Staphylococcus was diagnosed.
- Infection was linked to contaminated bandage contact lens use post-CXL.
Implications:
- While CXL is promising for keratoconus, secondary infections are a significant concern.
- Strict adherence to contact lens hygiene protocols is essential after CXL.
- Further research is needed on UV light's impact on corneal immunity and healing post-CXL.
