UV-A Collagen Cross-Linking Treatment of Bullous Keratopathy Combined With Corneal Ulcer

Cornea. 2010 Feb;29(2):235-8. doi: 10.1097/ICO.0b013e3181a81802.


Purpose: To evaluate the therapeutic effect of corneal cross-linking (CXL) in 2 cases of bullous keratopathy combined with corneal ulcer.

Methods: Two patients (2 eyes) were recruited for the sake of the study. Both suffered from bullous keratopathy and presented a gradually deteriorating, vision-threatening, central corneal ulcer, despite intense local antibiotic therapy. The same surgical procedure was performed in both eyes. De-epithelialization of the affected corneas was accompanied by UV-A cross-linking and finally by the application of a therapeutic contact lens. Local antibiotic therapy was resumed after the procedure.

Results: Within 24 hours of the treatment, both patients reported significant subjective improvement of their visual acuity and ocular discomfort. Clinical evaluation revealed improvement of the corneal ulcer and the bullous keratopathy associated with significant decrease of the corneal thickness and haziness. During the 2-month follow-up period, a significant improvement of visual acuity was recorded in both cases.

Conclusion: CXL should be considered as a potential adjuvant therapeutic tool in patients with combined bullous keratopathy and infectious keratitis, who are resistant to traditional topical therapy.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Blister / drug therapy*
  • Blister / metabolism
  • Collagen / metabolism*
  • Corneal Stroma / metabolism*
  • Corneal Ulcer / drug therapy*
  • Corneal Ulcer / metabolism
  • Dilatation, Pathologic / prevention & control
  • Female
  • Humans
  • Male
  • Photochemotherapy*
  • Photosensitizing Agents / therapeutic use*
  • Riboflavin / therapeutic use*
  • Ultraviolet Rays
  • Visual Acuity / physiology


  • Photosensitizing Agents
  • Collagen
  • Riboflavin