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Significant visual increase following infectious keratitis after collagen cross-linking.
J Refract Surg. 2012 Aug; 28(8):587-8.JR

Abstract

PURPOSE

To report a patient who developed a left paracentral stromal scar due to infectious keratitis that occurred after corneal collagen cross-linking (CXL) for progressive keratoconus. The flattening effect of the scar led to an increase in visual acuity.

METHODS

The corneal scar and flattening effect on the anterior corneal curvature were assessed by slit-lamp photography, high-resolution Scheimpflug imaging, and corneal confocal microscopy.

RESULTS

Three days after CXL, a corneal bacterial infection occurred in the left cornea and was treated with local antibiotics that led to a paracentral scar. Twenty-one days after CXL, a flattening of the anterior curvature of >11.00 diopters was observed. As a consequence, corrected distance visual acuity improved by five lines.

CONCLUSIONS

Corneal remodeling may lead to a homogenization of the anterior corneal surface and an increase in visual acuity. Remodeling may not only occur spontaneously following CXL, but also following an event that results in focal corneal scarring, such as corneal infection. In a highly irregular keratoconic cornea, the benefit of the flattening effect of a scar may outweigh the increase in aberrations and light scatter.

Authors+Show Affiliations

Department of Ophthalmology, Geneva University Hospitals, Geneva, Switzerland. farhad@hafezi.ch

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

22785058

Citation

Hafezi, Farhad. "Significant Visual Increase Following Infectious Keratitis After Collagen Cross-linking." Journal of Refractive Surgery (Thorofare, N.J. : 1995), vol. 28, no. 8, 2012, pp. 587-8.
Hafezi F. Significant visual increase following infectious keratitis after collagen cross-linking. J Refract Surg. 2012;28(8):587-8.
Hafezi, F. (2012). Significant visual increase following infectious keratitis after collagen cross-linking. Journal of Refractive Surgery (Thorofare, N.J. : 1995), 28(8), 587-8. https://doi.org/10.3928/1081597X-20120628-01
Hafezi F. Significant Visual Increase Following Infectious Keratitis After Collagen Cross-linking. J Refract Surg. 2012;28(8):587-8. PubMed PMID: 22785058.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Significant visual increase following infectious keratitis after collagen cross-linking. A1 - Hafezi,Farhad, Y1 - 2012/07/13/ PY - 2012/03/05/received PY - 2012/05/31/accepted PY - 2012/7/13/entrez PY - 2012/7/13/pubmed PY - 2012/8/31/medline SP - 587 EP - 8 JF - Journal of refractive surgery (Thorofare, N.J. : 1995) JO - J Refract Surg VL - 28 IS - 8 N2 - PURPOSE: To report a patient who developed a left paracentral stromal scar due to infectious keratitis that occurred after corneal collagen cross-linking (CXL) for progressive keratoconus. The flattening effect of the scar led to an increase in visual acuity. METHODS: The corneal scar and flattening effect on the anterior corneal curvature were assessed by slit-lamp photography, high-resolution Scheimpflug imaging, and corneal confocal microscopy. RESULTS: Three days after CXL, a corneal bacterial infection occurred in the left cornea and was treated with local antibiotics that led to a paracentral scar. Twenty-one days after CXL, a flattening of the anterior curvature of >11.00 diopters was observed. As a consequence, corrected distance visual acuity improved by five lines. CONCLUSIONS: Corneal remodeling may lead to a homogenization of the anterior corneal surface and an increase in visual acuity. Remodeling may not only occur spontaneously following CXL, but also following an event that results in focal corneal scarring, such as corneal infection. In a highly irregular keratoconic cornea, the benefit of the flattening effect of a scar may outweigh the increase in aberrations and light scatter. SN - 1081-597X UR - https://www.unboundmedicine.com/medline/citation/22785058/Significant_visual_increase_following_infectious_keratitis_after_collagen_cross_linking_ L2 - https://www.healio.com/doiresolver?doi=10.3928/1081597X-20120628-01 DB - PRIME DP - Unbound Medicine ER -