Massive corneal edema treated with corneal cross-linking

Massive corneal edema disrupts the fine architecture of corneal stroma that guarantees its transparency, causing opacities that seriously impair clear vision and are usually solved by corneal transplant. Corneal cross-linking, a treatment developed to halt keratoconus progression, results in a loss of water and a compaction of corneal stroma. It might therefore be useful to improve the pathologic edematous condition of some corneas, ameliorating visual acuity and allowing more time for a surgical procedure of keratoplasty.

Six patients with visual impairing corneal edemas further to lens phacoemulsification, penetrating keratoplasty, or post-infective neovascularization were treated with corneal cross-linking alone, or in combination with amniotic membrane apposition with or without anti-angiogenic therapy.

All patients partly resolved the edematous condition, improving both corneal transparency and visual acuity.

Corneal cross-linking appears to be a useful method to treat massive corneal edemas, so that keratoplasty can be at least delayed, and need not to be an emergency treatment in these cases.