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Infectious Keratitis Treated With Corneal Crosslinking

Makdoumi, Karim MD; Mortensen, Jes MD; Crafoord, Sven MD, PhD

doi: 10.1097/ICO.0b013e3181d2de91
Clinical Science

Purpose: To describe 7 eyes with severe infectious keratitis treated using collagen crosslinking (CXL) with riboflavin.

Materials and Methods: Seven eyes of 6 patients with severe infectious keratitis were treated with corneal crosslinking. Three patients were contact lens users. Symptom duration before CXL ranged between 0 and 7 days. Corneal melting was present in all cases. Photodocumentation of the keratitis was carried out and repeated at follow-up. All but 1 patient received topical antibiotic treatment in addition to the CXL treatment. CXL was conducted according to the standardized protocol for keratoconus.

Results: In all but 1 eye, patients experienced improvement in symptoms within 24 hours. Two patients reported no symptoms whatsoever at this time. Corneal melting was arrested and complete epithelialization was achieved in all cases. In the 2 eyes with hypopyon, this regressed completely within 2 days after the CXL. Follow-up ranged between 1 and 6 months.

Discussion: Our experience based on the above and other cases suggest that CXL could be an effective tool in battling difficult cases of infectious keratitis. This treatment could present many advantages but will need further investigation.

From the Department of Ophthalmology, Örebro University Hospital, Örebro, Sweden.

Received for publication December 18, 2008; revision received June 16, 2009; accepted January 2, 2010.

This article was in part presented as a paper in the fourth international congress on corneal collagen cross-linking, December 5-6, 2008, Dresden, Germany.

Reprints: Karim Makdoumi, Department of Ophthalmology, Örebro University Hospital, SE-701 85 Örebro, Sweden (e-mail:

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