SEVERE RING INFILTRATES FOLLOWING CROSSLINKING FOR KERATOCONUS

To emphasize the importance of topical post-operative steroids following corneal crosslinking.

Key words: Outcomes After Collagen Crosslinking for Keratoconus, Complications Of Collagen Crosslinking for Keratoconus.

Post-operative setting following corneal crosslinking, at Peterborough City Hospital Eye Department, North West Anglia Foundation Trust.

A 20 year-old Caucasian male with baseline right best-corrected visual acuity (BCVA) of 6/12, and left BCVA 6/6, had uncomplicated right corneal crosslinking for keratoconus. He presented 2 days later to the eye department with a red and painful eye. On examination, his right BCVA was counting fingers (CF), and his left BCVA was 6/6. He had right conjunctival injection, a superior ring infiltrate, and central haze. On further questioning, it was established that he had misunderstood the post-operative instructions and only used topical anaesthesia, but not any steroid or antibiotic. A much longer post-operative course with topical steroids has resulted in an improvement of his right BCVA to 6/24.

Corneal crosslinking causes a marked inflammatory response, and topical steroids are crucial for maintaining corneal clarity post-operatively.