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Infectious keratitis after corneal crosslinking: systematic review.
Caroline E Murchison1, W Matthew Petroll, Danielle M Robertson
1From the Department of Ophthalmology, UT Southwestern Medical Center, Dallas, Texas.
Journal of Cataract and Refractive Surgery
|March 26, 2021
Summary
Infection risk after epithelial-off corneal crosslinking is low, with bacterial keratitis being most common. Steroids, bandage contact lenses, and pre-existing conditions like atopic disease may increase infection risk.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Infectious Disease
Background:
- Corneal crosslinking (CXL) is FDA-approved for keratoconus.
- The standard epithelial-off CXL involves epithelium removal before treatment.
- Variations include accelerated and transepithelial CXL.
Purpose of the Study:
- To review infection risk after epithelial-off CXL.
- To identify the spectrum of pathogens involved.
- To assess clinical outcomes of infectious keratitis post-CXL.
Main Methods:
- Systematic review of 26 publications.
- Analysis of reported infections, pathogens, and outcomes.
- Inclusion of eyes fitted with bandage contact lenses postoperatively.
Main Results:
- Overall frequency of infectious keratitis is low.
- Bacterial infections are the most common type.
- Infection presentation averaged 4.8 days postoperatively.
- Steroids, bandage contact lenses, and atopic/herpetic disease history were associated with infection.
Conclusions:
- Epithelial-off CXL has a low risk of infectious keratitis.
- Close postoperative monitoring is crucial.
- Prophylactic antiviral therapy may be needed for high-risk patients.
