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Central toxic keratopathy post cross-linking

Poster Details

First Author: N.Al Raqqad JORDAN

Co Author(s):    M. Al Yarabi   M. AL Tarawneh                 

Abstract Details


To describe a case series of central toxic keratopathy presenting after cross-linking in Jordan.


King Hussein Medical Center Al Jazeerah Hospital Specialty Eye hsopital Amman, Jordan


Five cases of central toxic keratopathy CTK were seen within a two-month period after cross linking at king Hussein Medical Center and elsewhere. patients developed central corneal thining, hyperopic shift and striation within one week of the procedure. corneal infection was excluded. Cases that were cross-linked at KHMC underwent epi off accelerated CXL mode with density of 5.4 J/Cm2, intensity of 9 mW/Cm2, over 8 mm for 10 minutes. The Riboflavin used is Ricrolin( Sooft, Italia). epioff protocol was also used in the two other patients with no clear data about duration of their treatment.


All affected patients were examined, treated and followed up at 1 week, 1 month, 3 months and 6 months. Data collected included: visual acuity, BCVA, refraction, slit lamp biomicroscopy, pentacam topography (Oculus), and anterior segment optical coherence tomography.


CTK is an acute rare complication of corneal refractive as well as corneal debridement procedures like CXL. It is a self-limiting condition. Meticulous precautions regarding the use of antiseptic, latex free gloves and preop lid margin treatment may reduce its prevalence. The use of accelerated mode could probably have a related issue that needs to be studied further. Initial steroid treatment can play a role in decreasing the sequalae of this condition. Further studies needed to highlight the specific causes.

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