In Situ Corneal Cross-Linking for Recurrent Corneal Melting After Boston Type 1 Keratoprosthesis. Issue 6 (June 2016)

• Record Type: Journal Article
• Authors: Tóth, Gábor; Bucher, Franziska; Siebelmann, Sebastian; Bachmann, Björn; Hermann, Manuel; Szentmáry, Nóra; Nagy, Zoltán Zsolt; Cursiefen, Claus
• Is Part Of: Cornea. Volume 35:Issue 6(2016)
• Publication Date: 2016-06
• Subjects: Boston type I keratoprosthesis -- corneal melting -- cross-linking; Cornea -- Periodicals; Cornea -- Periodicals; Cornée -- Périodiques; 617.719
• DOI: 10.1097/ICO.0000000000000830
• Languages: English
• ISSNs: 0277-3740

Abstract

Abstract : Purpose: To present a new treatment modality for recurrent corneal melting in a patient with a Boston type I keratoprosthesis (B-KPro) including in situ corneal cross-linking (CXL) and lamellar keratoplasty (LKP) as combined treatment. Methods: Case report. Results: Our report concerns a 27-year-old man whose case history involved a severe chemical burn of his left eye. After failed penetrating keratoplasty and limbal stem cell transplantation, the patient underwent B-KPro implantation. Starting 1 month after surgery, recurrent corneal melting around the B-KPro developed, which was eventually treated by combining LKP, amniotic membrane transplantation, and in situ CXL. Optical coherence tomography imaging and follow-up for 12 months showed stable corneal healing without new melting or erosion. The ultraviolet A treatment did not seem to damage the material of the B-KPro. Conclusions: In situ CXL using riboflavin and ultraviolet A light combined with LKP and amniotic membrane transplantation can be an effective management option to treat recurrent corneal melting after B-KPro implantation.