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First Author: D.Ozarslan Ozcan TURKEY
Co Author(s): S. Akkaya Turhan U. Taka Ayd?n E. Toker
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The purpose of this study was to evaluate the confocal microscopic morphology and anterior segment optical coherence tomography (AS-OCT) findings of peripheral sterile corneal infiltrates after corneal collagen cross-linking (CXL).
Marmara University School of Medicine, Istanbul, Turkey
In this report we present eleven cases who developed sterile infiltrates in the immediate postoperative periods. These cases were evaluated with in vivo confocal microscopy and AS-OCT.
Eleven eyes of eleven patients were evaluated with confocal microscopy and AS-OCT. These patients with keratoconus stage 2 to 3 underwent uneventful epithelium- off CXL . Postoperatively, topical antibiotics and anti-inflamatory drops was initiated. Two or three days after CXL treatment, patients presented with symptoms of inflammation such as pain, redness and blurring of vision in treated eye. Slit-lamp biomicroscopy revealed unusual stromal infiltration in the peripheral margin of epithelial debridement zone. Corneal cultures were negative. The postoperative confocal analysis confirmed non-specific inflammation findings. At the depth of 50-100 ṁm, hyper-reflective small dots ,structures and dendritic cells were observed. The results were nonspecific . AS- OCT showed that sterile infiltrates localized at epithelium and anterior stroma ranging in a depth of 100-140 ṁm corneal thickness. A diagnosis noninfective keratitis was made, and the patients were started on hourly preservative-free moxifloxacin and dexamethasone. A few week later, much of the peripheral infiltrations had disappeared.
In vivo confocal microscopy is a rapid and non-invasive tool for rapid evaluation of all corneal layers and peripheral sterile infiltrates. We report eleven cases of peripheral sterile infiltrates from a total of 444 eyes.To the best of our knowledge, this study is the first to examine the confocal microscopic features of this relatively uncommon and etiologically poorly defined complication of peripheral sterile infiltrates after CXL.