Sterile Corneal Infiltrates After Combined Riboflavin-UVA Corneal Collagen Cross-Linking for Keratoconus

Purpose To investigate sterile corneal infiltrate seen in 14 patients after accelerated corneal collagen cross-linking (CXL) for keratoconus. Setting: Baskent University, Faculty of Medicine, Adana Clinic and Research Center, Ophthalmology Department. Methods The records for all 300 eyes of 190 cases who underwent corneal collagen cross-linking were reviewed retrospectively. Our approach for CXL was the epithelial-off surgical technique, which involved corneal de-epithelization with the administration of riboflavin for 30 minutes and exposure to 9 mW/cm ² ultraviolet-A for 10 minutes. Results Corneal stromal infiltrate was observed in 14 of our patients after uneventful CXL treatment. Eight of the 14 patients had allergic conjunctivitis. The infiltrates were located in the anterior superficial stroma in the 9 mm peripheral region in 13 patients and centrally located in one patient. No microorganism growth seen in the samples. Corneal infiltrates were treated with topical steroids, antibiotics, and artificial tears in all patients. Complete recovery was achieved in all cases after several weeks of treatment. Conclusion Patients with allergic conjunctivitis are at increased risk of developing sterile corneal infiltrates. Corneal infiltrates can improve and resolve with appropriate treatment. Visual outcomes are good despite this complication.