Abstract
P 032
Peripheral sterile infiltrates and corneal infection after cross linking for the treatment of keratokonus
David Arthur Märker, Horst Helbig, Wolfgang Herrmann
Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Regensburg, Regensburg
Purpose
Report of two possible complications (peripheral sterile infiltrates and bacterial keratitis) after collagen cross linking for the treatment of keratokonus.
Methods
Case reports of two patients being medicated at the ophthalmolgical department of the University Regensburg after external cross linking for the treatment keratokonus.
Case 1: A 19-year-old man presented with severe foreign body sensation and conjunctival injection of the right eye six days after cross linking for the treatment of keratokonus. On
examination the corneal stroma showed four white peripheral infiltrates and Tyndall. A corneal scraping was performed. PCR was negative for fungi and bacteria. After five days of intensive steroid treatment the infiltrates confined and resulted in hazy opacities.
Case 2: A 44-year-old female presented 6 days post operation with severe pain and redness of the left eye. Clinically the eye showed a central infiltrate with beginning ulceration of the cornea and 2-3mm hypopyon. Initially she was treated with a combination of Neomycin, Polymyxin B and Dexamethasone. Treatment was modified to fortified Ceftazidim - and Tobramycin - and additional Ofloxacin eye drops. PCR and cultures were negative for bacteria. In the follow-up the cornea showed a central ulcus with beginning cicatrization. In the follow up best corrected visiual acuity was <0,1 due to a central consolidated scar, therefore penetrating keratoplasty is planned.
Discussion
Cross linking is an upcoming technique undergiong clinical evaluation for the treatment of reduced corneal mechanical stability in keratoconus and similar corneal diseases.
Both, sterile infiltrates and corneal infection are possible complications of corneal cross linking. For precocoius diagnosis and therapy close check ups during the early postoperative stage are strongly recommened.
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