|Year : 2022 | Volume
| Issue : 3 | Page : 841
It is cross-linking or hydrating!
Venugopal Anitha, Aditee Madkaikar
Cornea and Refractive Services, Aravind Eye Hospital and Post Graduate Institution, Tirunelveli, Tamil Nadu, India
|Date of Web Publication||16-Jul-2022|
Dr. Venugopal Anitha
Cornea and Refractive Services, Aravind Eye Hospital and Post Graduate Institution, Tirunelveli - 627 001, Tamil Nadu
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Anitha V, Madkaikar A. It is cross-linking or hydrating!. Indian J Ophthalmol Case Rep 2022;2:841
A 24-year-old female was diagnosed with bilateral progressive keratoconus and confirmed with Pentacam. She underwent isotonic corneal collagen cross-linking with riboflavin because the thinnest pachymetry was 445 mm in the left eye. She had severe stromal edema (CE) [Figure 1]a even though her pre-op specular was normal (cell density: 2667 cells/mm2, hexagonality: 80%). Post-operatively, ultra-sound pachymetry [central corneal thickness (CCT)] revealed 884 mm in the center, and after 3 months, the CCT was 435 mm [Figure 1]b. The endothelial phototoxic level is 0.35 mW/cm2, and a minimal corneal thickness of 400 um is required for safe surface irradiance (5.4 mJ/cm). CE might be because of improper calibration, improper focussing/irradiance of UV light, or inadequate instillation of riboflavin, delivering higher energies above the cytotoxic threshold. Hence, it is recommended to follow the standard protocols before the procedure even in thicker corneas.
|Figure 1: (a) Severe stromal edema post corneal cross-linking (CXL) with riboflavin on day 1 post op. (b) Resolved corneal edema 3 months after CXL|
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Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
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Conflicts of interest
There are no conflicts of interest.
| References|| |
Spoerl E, Mrochen M, Sliney D, Trokel S, Seiler T. Safety of UVA-riboflavin cross-linking of the cornea. Cornea 2007;26:385-9.