Related Experiment Video
Updated: Jun 21, 2025
07:29
Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis
Published on: November 12, 2015
19.9K
Late-onset corneal edema after customized crosslinking for progressive keratoconus
Magali M S Vandevenne1, Tos T J M Berendschot1, Nienke Visser1
1Maastricht University Medical Centre+ University Clinic of Ophthalmology, the Netherlands, P.O. box 5800, 6202 AZ Maastricht, the Netherlands.
American Journal of Ophthalmology Case Reports
|July 10, 2024
Summary
A patient experienced corneal edema after customized crosslinking (CXL) for keratoconus, which resolved spontaneously. This case highlights the importance of stromal thickness during CXL to prevent complications.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Biomaterials Science
Background:
- Progressive keratoconus necessitates advanced treatments like customized corneal crosslinking (CXL).
- Corneal crosslinking aims to strengthen the cornea and halt keratoconus progression.
- Customized CXL offers tailored treatment but requires careful parameter optimization.
Observation:
- A 24-year-old male with keratoconus underwent customized CXL (10 J/cm² for 16.4 min).
- Post-procedure, the patient developed microcystic corneal edema and reduced visual acuity at 4 months.
- Corneal edema and visual acuity spontaneously resolved within one month.
Findings:
- The patient experienced transient corneal edema and endothelial cell loss post-customized CXL.
- Corneal thickness and visual acuity returned to near-baseline levels after spontaneous resolution.
- Confocal microscopy revealed normal stromal changes with the demarcation line above the endothelium.
Implications:
- Maintaining a minimum stromal thickness of 400 μm during UV-A irradiation is crucial.
- Alternative strategies like using a contact lens or adjusting irradiation may prevent CXL-induced edema.
- This case underscores the need for vigilant monitoring and potential protocol adjustments in customized CXL procedures.
Related Concept Videos
01:28Angle Closure Glaucoma: Treatment
470
Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
470
01:25Glaucoma: Overview
538
Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
538
01:27Open Angle Glaucoma: Treatment
427
In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
Drugs such as carbonic anhydrase inhibitors, α2- and...
Drugs such as carbonic anhydrase inhibitors, α2- and...
427