Open AccessInfectious keratitis after corneal crosslinking: systematic review
Author(s) -
Caroline E. Murchison,
Walter M Petroll,
Danielle M. Robertson
Publication year - 2021
Publication title -
journal of cataract and refractive surgery/journal of cataract and refractive surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 142
eISSN - 1873-4502
pISSN - 0886-3350
DOI - 10.1097/j.jcrs.0000000000000620
Subject(s) - medicine , keratitis , keratoconus , bandage , corneal epithelium , cornea , contact lens , ophthalmology , surgery , ectasia , dermatology
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.