ESCRS - POCOR328 - Tear Lactoferrin Changes After Corneal Collagen Cross-Linking In A 17-Year-Old Patient With Bilateral Primary Corneal Ectasia - A Case Report

Tear Lactoferrin Changes After Corneal Collagen Cross-Linking In A 17-Year-Old Patient With Bilateral Primary Corneal Ectasia - A Case Report

Published 2026 - 44th Congress of the ESCRS

Reference: POCOR328 | Type: Poster | DOI: 10.82333/f2pk-3108

Authors: Dr Kamilla Bazarbaeva* 1 , Prof. Dr Azamat Yusupov 2 , Dr Ahmadjon Nozimov 1 , Dr Guzal Yusupova 3

1Ophthalmology,Republican Specialized Scientific and Practical Medical Centre of Eye Microsurgery,Tashkent,Uzbekistan, 2Laser surgery ,Republican Specialized Scientific and Practical Medical Centre of Eye Microsurgery,Tashkent,Uzbekistan, 3Ophthalmology,Sihat Oila private clinic,Tashkent,Uzbekistan

Purpose

To assess tear lactoferrin changes and clinical outcomes after CXL in a teenager with bilateral primary corneal ectasia.

Setting

A 17-year-old patient with bilateral progressive primary corneal ectasia treated with corneal collagen cross-linking (CXL) at the RSSPMCEM, Tashkent, Uzbekistan.

Examinations before and at 3 months (September - November 2025) included visual acuity, refraction, IOP (iCare), Pachymetry (Heidelberg Anterior OCT), and Scheimpflug Tomography (Pentacam). Tear lactoferrin was measured before and 3 months after CXL using ELISA (FineTEST kit, 1:100 dilution).

Methods

A 17-year-old patient with bilateral progressive primary corneal ectasia underwent standard corneal collagen cross-linking (Dresden protocol; riboflavin plus UVA 3 mW/cm² for 30 min, total 5.4 J/cm²). Examinations preoperatively and at 3 months included UCVA, BCVA, refraction, slit-lamp, and IOP. Corneal imaging used anterior segment OCT and Pentacam HR. Pentacam showed Amsler–Krumeich stage 2 keratoconus (K 48–52 D, inferior steepening, thinnest 398–404 µm, posterior elevation, abnormal BAD-D) without progression. Tear lactoferrin was measured by ELISA (FineTEST kit, 1:100 dilution).

Results

At 3 months after bilateral CXL, both eyes showed improvement and stabilization. In OD, UCVA improved from ~20/67–20/50 to 20/40 and BCVA from ~20/29 to 20/22. In OS, UCVA improved from ~20/100 to 20/50 and BCVA from 20/50 to 20/33. Refraction showed mild reduction of spherical and cylindrical error. IOP remained normal (12/11 mmHg). AS-OCT showed stable thickness (404→408 µm OD; 399→402 µm OS). Pentacam confirmed stability. Tear lactoferrin rose from 0.11 to 1.29 mg/mL (OD) and 0.15 to 0.85 mg/mL (OS), indicating biochemical improvement after CXL.

Conclusions

  1. CXL resulted in visual and refractive improvement in this adolescent patient
  2. Corneal thickness remained stable
  3. Tear lactoferrin levels increased markedly after CXL
  4. Findings suggest improved ocular surface biochemical status post-treatment