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Late-onset corneal edema after customized crosslinking for progressive keratoconus.
Vandevenne, Magali M S; Berendschot, Tos T J M; Visser, Nienke; Dickman, Mor M; Nuijts, Rudy M M A.
Afiliación
  • Vandevenne MMS; Maastricht University Medical Centre+ University Clinic of Ophthalmology, the Netherlands, P.O. box 5800, 6202 AZ Maastricht, the Netherlands.
  • Berendschot TTJM; Maastricht University Medical Centre+ University Clinic of Ophthalmology, the Netherlands, P.O. box 5800, 6202 AZ Maastricht, the Netherlands.
  • Visser N; Maastricht University Medical Centre+ University Clinic of Ophthalmology, the Netherlands, P.O. box 5800, 6202 AZ Maastricht, the Netherlands.
  • Dickman MM; Maastricht University Medical Centre+ University Clinic of Ophthalmology, the Netherlands, P.O. box 5800, 6202 AZ Maastricht, the Netherlands.
  • Nuijts RMMA; Maastricht University Medical Centre+ University Clinic of Ophthalmology, the Netherlands, P.O. box 5800, 6202 AZ Maastricht, the Netherlands.
Am J Ophthalmol Case Rep ; 35: 102090, 2024 Sep.
Article en En | MEDLINE | ID: mdl-38983453
ABSTRACT

Purpose:

We describe a patient after customized crosslinking (CXL) for progressive keratoconus who developed corneal edema with spontaneous resolution. Observations A 24-year-old male with progressive keratoconus of the left eye underwent a customized CXL procedure with a total energy of 10 J/cm2 for 16.4 minutes. Preoperative corrected distance visual acuity (CDVA) was 20/30 with a maximum keratometry (K)-value of 58.6 diopter (D) and the thinnest point measured 414 µm. The preoperative endothelial cell density (ECD) was 2414 cells/mm2. During treatment, corneal thickness was 325 µm after epithelial debridement and 375 µm after the application of 0.1 % riboflavin containing HPMC. After the treatment, antibiotic and steroid drops were prescribed for 5 days and 3 weeks, respectively. At the 1-month post-CXL visit the patient had no complaints, visual acuity and clinical examination showed no irregularities. At the 4-months post-CXL visit the patient complained of blurry vision. The CDVA was 20/100 and slit-lamp examination showed microcystic corneal edema. The corneal thickness at the thinnest point measured 440 µm. One month later the edema had resolved spontaneously and CDVA had restored to 20/25. Corneal thickness at the thinnest point measured 415 µm, the ECD was 1514 cells/mm2 and confocal microscopy showed normal structural changes in the anterior stroma after CXL, with the demarcation line located at a depth of 414 µm, just above the corneal endothelium. Conclusions and importance We report a case of corneal edema following customized CXL with endothelial cell loss that resolved spontaneously. We recommend either adhering to a minimal stromal thickness of 400 µm before administering UV-A irradiation, using a contact lens or adjusting the irradiation to prevent this complication.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Am J Ophthalmol Case Rep Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Am J Ophthalmol Case Rep Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos