TY - JOUR
T1 - Infectious keratitis after corneal crosslinking
T2 - systematic review
AU - Murchison, Caroline E.
AU - Petroll, W. Matthew
AU - Robertson, Danielle M.
N1 - Publisher Copyright:
© 2021 Elsevier Inc.. All rights reserved.
PY - 2021/8/1
Y1 - 2021/8/1
N2 - 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.
AB - 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.
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U2 - 10.1097/j.jcrs.0000000000000620
DO - 10.1097/j.jcrs.0000000000000620
M3 - Review article
C2 - 33769765
AN - SCOPUS:85112589462
SN - 0886-3350
VL - 47
SP - 1075
EP - 1080
JO - Journal of Cataract and Refractive Surgery
JF - Journal of Cataract and Refractive Surgery
IS - 8
ER -