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OPHTHALMIC IMAGE
Year : 2022  |  Volume : 2  |  Issue : 3  |  Page : 841

It is cross-linking or hydrating!


Cornea and Refractive Services, Aravind Eye Hospital and Post Graduate Institution, Tirunelveli, Tamil Nadu, India

Date of Web Publication16-Jul-2022

Correspondence Address:
Dr. Venugopal Anitha
Cornea and Refractive Services, Aravind Eye Hospital and Post Graduate Institution, Tirunelveli - 627 001, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1067_22

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How to cite this article:
Anitha V, Madkaikar A. It is cross-linking or hydrating!. Indian J Ophthalmol Case Rep 2022;2:841

How to cite this URL:
Anitha V, Madkaikar A. It is cross-linking or hydrating!. Indian J Ophthalmol Case Rep [serial online] 2022 [cited 2022 Oct 6];2:841. Available from: https://www.ijoreports.in/text.asp?2022/2/3/841/351115



A 24-year-old female was diagnosed with bilateral progressive keratoconus and confirmed with Pentacam. She underwent isotonic corneal collagen cross-linking with riboflavin because the thinnest pachymetry was 445 mm in the left eye. She had severe stromal edema (CE) [Figure 1]a even though her pre-op specular was normal (cell density: 2667 cells/mm2, hexagonality: 80%). Post-operatively, ultra-sound pachymetry [central corneal thickness (CCT)] revealed 884 mm in the center, and after 3 months, the CCT was 435 mm [Figure 1]b. The endothelial phototoxic level is 0.35 mW/cm2, and a minimal corneal thickness of 400 um is required for safe surface irradiance (5.4 mJ/cm).[1] CE might be because of improper calibration, improper focussing/irradiance of UV light, or inadequate instillation of riboflavin, delivering higher energies above the cytotoxic threshold. Hence, it is recommended to follow the standard protocols before the procedure even in thicker corneas.
Figure 1: (a) Severe stromal edema post corneal cross-linking (CXL) with riboflavin on day 1 post op. (b) Resolved corneal edema 3 months after CXL

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Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Spoerl E, Mrochen M, Sliney D, Trokel S, Seiler T. Safety of UVA-riboflavin cross-linking of the cornea. Cornea 2007;26:385-9.  Back to cited text no. 1
    


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