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Vienna 2018 Delegate Registration Programme Exhibition Virtual Exhibition Satellites 2018 Survey


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Shield ulcer formation after cross-linking for keratoconus

Poster Details

First Author: D.Wajnsztajn Vamos ISRAEL

Co Author(s):    A. Solomon   D. Landau   J. Frucht-Pery              

Abstract Details


To report the development of shield ulcer (SU) after Corneal Collagen Cross-linking treatment (CXL) for progressing keratoconus (KC) in 2 eyes of 2 patients.


Hadassah Medical Center – Hebrew University Hospital


Retrospective review of the files of the 2 patients who had CXL for KC followed by SU formation. CXL was performed with hypotonic riboflavin and accelerated (10 min) protocol (UV-X ™ Specifications, IROC, Zurich, Switzerland).


Patients were 12 and 15 years old. Both had history of vernal keratoconjunctivitis (VKC) with SU surgically removed (one had it in the same eye 6 months before and the other in the contralateral eye 4 years before). Both eyes had no active VKC at CXL; both had complete epithelialization with contact lens 1 week post-CXL but had corneal erosion and SU formation 2.5 and 4.5 weeks post-CXL under topical steroids. In both, SU healing failed with clinical treatment and improved after surgical removal of the SU 6 and 7 weeks from the initial erosion. Visual acuity was not affected.


Post-CXL inflammation in patients with VKC and past history of SU formation may have greater risk of SU development. Patients with VKC and past history of SU should be carefully followed after CXL for KC even under topical steroid treatment.

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