Infectious keratitis treated with corneal crosslinking

Cornea. 2010 Dec;29(12):1353-8. doi: 10.1097/ICO.0b013e3181d2de91.


Purpose: To describe 7 eyes with severe infectious keratitis treated using collagen crosslinking (CXL) with riboflavin.

Materials and methods: Seven eyes of 6 patients with severe infectious keratitis were treated with corneal crosslinking. Three patients were contact lens users. Symptom duration before CXL ranged between 0 and 7 days. Corneal melting was present in all cases. Photodocumentation of the keratitis was carried out and repeated at follow-up. All but 1 patient received topical antibiotic treatment in addition to the CXL treatment. CXL was conducted according to the standardized protocol for keratoconus.

Results: In all but 1 eye, patients experienced improvement in symptoms within 24 hours. Two patients reported no symptoms whatsoever at this time. Corneal melting was arrested and complete epithelialization was achieved in all cases. In the 2 eyes with hypopyon, this regressed completely within 2 days after the CXL. Follow-up ranged between 1 and 6 months.

Discussion: Our experience based on the above and other cases suggest that CXL could be an effective tool in battling difficult cases of infectious keratitis. This treatment could present many advantages but will need further investigation.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Collagen / metabolism*
  • Corneal Stroma / metabolism*
  • Corneal Ulcer / drug therapy*
  • Corneal Ulcer / metabolism
  • Corneal Ulcer / microbiology
  • Cross-Linking Reagents / therapeutic use*
  • Eye Infections, Bacterial / drug therapy*
  • Eye Infections, Bacterial / metabolism
  • Eye Infections, Bacterial / microbiology
  • Female
  • Haemophilus Infections / drug therapy*
  • Haemophilus Infections / metabolism
  • Haemophilus Infections / microbiology
  • Haemophilus influenzae / isolation & purification
  • Humans
  • Male
  • Middle Aged
  • Moraxella / isolation & purification
  • Moraxellaceae Infections / drug therapy*
  • Moraxellaceae Infections / metabolism
  • Moraxellaceae Infections / microbiology
  • Photosensitizing Agents / therapeutic use
  • Riboflavin / therapeutic use
  • Ultraviolet Rays


  • Cross-Linking Reagents
  • Photosensitizing Agents
  • Collagen
  • Riboflavin