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Updated: Jun 3, 2026
Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis
Published on: November 12, 2015
Keratopathy after cross-linking for keratoconus
Paz Rodríguez-Ausín1, Ramón Gutiérrez-Ortega, Angeles Arance-Gil
1Department of Ophthalmology, Hospital Gregorio Marañon, Madrid, Spain. pazrausin@telefonica.net
Purpose:
To report 2 cases of keratopathy after uneventful cross-linking procedures for grade 3 keratoconus.
Methods:
Two patients (21 and 11 years old) with grade 3 keratoconus underwent uneventful cross-linking in 1 eye. In both patients, multiple peripheral stromal precipitates, which extended centripetally, were observed 48 hours after the procedure. Sample cultures were negative for bacteria, fungi, and parasites.
Results:
Cornea infiltrates slowly resolved after combined topical antibiotic/antifungal/povidone/steroids treatment. Final best spectacle-corrected visual acuity was 20/25 for patient 1, after uneventful bilateral toric intraocular contact lens (ICL) (Staar Surgical) implantation, but faint and paracentral scarring persisted. Final best-corrected visual acuity was 20/25 for patient 2 with gas-permeable contact lens wear, despite stromal scarring.
Conclusions:
Cross-linking associated with sterile keratitis is an unusual entity of unknown etiology, which can lead to stromal scarring.
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