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Published on: November 12, 2015
In Situ Corneal Cross-Linking for Recurrent Corneal Melting After Boston Type 1 Keratoprosthesis
Gábor Tóth1, Franziska Bucher, Sebastian Siebelmann
1*Department of Ophthalmology, Semmelweis University, Budapest, Hungary; †Department of Ophthalmology, University of Cologne, Cologne, Germany; and ‡Department of Ophthalmology, Saarland University Medical Center, Homburg, Saar, Germany.
Purpose:
To present a new treatment modality for recurrent corneal melting in a patient with a Boston type I keratoprosthesis (B-KPro) including in situ corneal cross-linking (CXL) and lamellar keratoplasty (LKP) as combined treatment.
Methods:
Case report.
Results:
Our report concerns a 27-year-old man whose case history involved a severe chemical burn of his left eye. After failed penetrating keratoplasty and limbal stem cell transplantation, the patient underwent B-KPro implantation. Starting 1 month after surgery, recurrent corneal melting around the B-KPro developed, which was eventually treated by combining LKP, amniotic membrane transplantation, and in situ CXL. Optical coherence tomography imaging and follow-up for 12 months showed stable corneal healing without new melting or erosion. The ultraviolet A treatment did not seem to damage the material of the B-KPro.
Conclusions:
In situ CXL using riboflavin and ultraviolet A light combined with LKP and amniotic membrane transplantation can be an effective management option to treat recurrent corneal melting after B-KPro implantation.
