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Late-onset deep corneal scarring after epithelium-off corneal cross-linking

Poster Details

First Author: P.Papadakou GREECE

Co Author(s):    M. Liontiris   G. Saitakis   M. Papathanassiou              

Abstract Details


To present a case of a late onset deep stromal scarring, in a 25-year-old patient, who underwent corneal cross-linking(CXL) for keratoconus.


Cornea Clinic, 2nd Ophthalmology Department, Attikon University Hospital,Athens, Greece


A 25-year-old patient with moderate keratoconus underwent Rivoflabin-UV-A CXL using the standard epithelium-off Dresden protocol in both eyes at 1 month apart.


Procedure was uneventful in both eyes.Epithelium was healed at 1 week and by month 6 topography was stable. At 1 year, best-corrected visual acuity(BCVA) was 20/40 in the right eye(RE) and 20/25 in the left eye(LE). Patient presented at 14-month follow up visit with decreased BCVA of 20/200 in LE. Slit lamp examination and anterior segment imaging showed a dense corneal opacity located in the posterior stroma on the visual axis. Patient was started on intensive topical prednisolone drops with a tapering scheme over the next month. Three months later scarring was significantly improved and LE BCVA improved to 20/40.


Late onset, even more than a year postoperatively, deep corneal scarring is a rare complication of epithelium-off CXL, which can significantly affect vision.

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