Infectious keratitis after corneal crosslinking: systematic review. Issue 8 (August 2021)

• Record Type: Journal Article
• Authors: Murchison, Caroline E.; Petroll, W. Matthew; Robertson, Danielle M.
• Is Part Of: Journal of cataract and refractive surgery. Volume 47:Issue 8(2021)
• Page Start: 1075
• Page End: 1080
• Publication Date: 2021-08
• Subjects: 617.7
• DOI: 10.1097/j.jcrs.0000000000000620
• Languages: English
• ISSNs: 0886-3350

Abstract

Abstract : Infectious keratitis after corneal crosslinking is low. The use of topical steroids, bandage contact lenses, and/or a history of atopic or herpetic disease are associated with infection. Abstract : Corneal crosslinking is a U.S. Food and Drug Administration-–approved therapy to stiffen the cornea and prevent progression of corneal ectasia in patients with keratoconus. The standard procedure involves removal of the corneal epithelium (epithelial-off) prior to treatment. Variations to the standard procedure include accelerated crosslinking and transepithelial procedures. This study reviewed what is known regarding the risk for infection after epithelial-off crosslinking, the spectrum of pathogens, and clinical outcomes. 26 publications were identified. All eyes were fit with a bandage contact lens postoperatively. Available data indicate that the overall frequency of infectious keratitis after epithelium-off crosslinking is low. Bacterial infections are the most common, with a mean time of presentation of 4.8 days postoperatively. The use of steroids and bandage contact lenses in the immediate postoperative period and/or a history of atopic or herpetic disease were associated with infection. These patients require intense postoperative care with prophylactic antiviral therapy when appropriate.