Infectious Keratitis After Accelerated Corneal Collagen Cross-Linking
Published 2026 - 44th Congress of the ESCRS
Reference: PP16.02 | Type: Free paper | DOI: 10.82333/1q1k-5b33
Authors: Dr Hemant Jhajharia* 1 , A/Prof. Namrata Sharma 1 , Dr Aafreen Bari 1 , A/Prof. Tushar Agarwal 1 , A/Prof. Neelam Pushkar 1
1Ophthalmology,Dr. R. P. Centre for Ophthalmic Sciences,Delhi,India
Purpose
To analyse the risk factors, clinical features, visual outcomes and in-vivo imaging characteristics in cases of
keratoconus developing keratitis following accelerated collagen cross linking (CXL).
Setting
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, a Tertiary Care Centre in India
Methods
A retrospective observational case series at a tertiary eye centre in India evaluating eyes that underwent
accelerated CXL from January 2021 to July 2024.
Results
Of 723 eyes undergoing CXL, 13 eyes developed infectious keratitis (1.79%). Bandage contact lens use was common to all. The mean duration from onset of symptoms to presentation was 2.7 ± 1.5 days. The most common clinical presentation was multifocal stromal infiltrates seen in 85.7% cases. Average resolution time was 18.4 ± 12.9 days. The most common organism isolated was CoNS, while others included S. aureus, E. coli, Candida sp. and Acanthameba sp. Resistance to fourth generation fluoroquinolones was observed in 60%. Involvement was mostly anterior to the demarcation line. Scheimpflug imaging showed greater flattening and thinning with scar
formation. In the early post-operative phase, transient steepening was observed in one case.
Conclusions
Infectious keratitis following accelerated CXL is a rare clinical entity. Early presentation, timely management
including use of topical steroids are associated with good visual outcomes.