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Updated: May 8, 2026
Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis
Published on: November 12, 2015
Microsporidial keratitis after collagen cross-linking
Gautam1, Vishal Jhanji, Gita Satpathy
1Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences , New Delhi , India and.
Purpose:
To report a case of infectious keratitis due to Microsporidium after collagen crosslinking (CXL).
Methods:
A 36-year-old man presented with a 3-day history of pain, redness and diminution of vision in his left eye. The patient had received CXL for keratoconus in the left eye 6 days prior to presentation. Best-corrected visual acuity (BCVA) was 20/25 OD and counting fingers OS. Slit lamp examination of the left eye showed a central epithelial defect measuring and multiple stromal infiltrates.
Results:
Gram and Giemsa staining of corneal scrapings showed spores characteristic of Microsporidia. Hourly 0.5% moxifloxacin eye drops, 0.5% moxifloxcain eye ointment nocte and oral albendazole 400 mg twice daily were commenced. Corneal debridement was performed twice during the first week. At the end of 6 weeks BCVA was 20/60 in the left eye.
Conclusions:
Microsporidial infection can be confirmed on microbiological examination. Our case responded well to medical treatment alone.
Insights
A rare case of Microsporidium infectious keratitis occurred after collagen crosslinking (CXL) for keratoconus. Prompt microbiological diagnosis and medical treatment, including albendazole, led to a favorable visual outcome.
Area of Science:
- Ophthalmology
- Microbiology
Background:
- Collagen crosslinking (CXL) is a standard treatment for progressive keratoconus.
- Infectious keratitis is a potential complication following ocular procedures.
Observation:
- A 36-year-old male developed infectious keratitis with significant vision loss in his left eye six days post-CXL.
- Clinical examination revealed a central epithelial defect and stromal infiltrates.
Findings:
- Corneal scrapings stained with Gram and Giemsa confirmed Microsporidia spores.
- The patient was treated with topical antibiotics, an antifungal agent, and oral albendazole.
- Corneal debridement was performed twice in the first week.
Implications:
- This case highlights Microsporidium as a causative agent of infectious keratitis after CXL.
- Early diagnosis and appropriate medical management, including albendazole, are crucial for successful treatment.
- Microsporidial keratitis following CXL can be effectively managed with medical therapy alone, preserving visual acuity.
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