title: Keratopathy after cross-linking for keratoconus.
abstract: OBJECTIVE
  To report 2 cases of keratopathy after uneventful cross-linking procedures for grade 3 keratoconus.
  
  
  METHODS
  Two patients (21 and 11 years old) with grade 3 keratoconus underwent uneventful cross-linking in 1 eye. In both patients, multiple peripheral stromal precipitates, which extended centripetally, were observed 48 hours after the procedure. Sample cultures were negative for bacteria, fungi, and parasites.
  
  
  RESULTS
  Cornea infiltrates slowly resolved after combined topical antibiotic/antifungal/povidone/steroids treatment. Final best spectacle-corrected visual acuity was 20/25 for patient 1, after uneventful bilateral toric intraocular contact lens (ICL) (Staar Surgical) implantation, but faint and paracentral scarring persisted. Final best-corrected visual acuity was 20/25 for patient 2 with gas-permeable contact lens wear, despite stromal scarring.
  
  
  CONCLUSIONS
  Cross-linking associated with sterile keratitis is an unusual entity of unknown etiology, which can lead to stromal scarring.
authors.affiliation: Department of Ophthalmology, Hospital Gregorio Marañon, Madrid, Spain. pazrausin@telefonica.net
authors.forename: Paz
authors.initials: P
authors.lastname: Rodríguez-Ausín
authors.forename: Ramón
authors.initials: R
authors.lastname: Gutiérrez-Ortega
authors.forename: Angeles
authors.initials: A
authors.lastname: Arance-Gil
authors.forename: Miguel
authors.initials: M
authors.lastname: Romero-Jimenez
authors.forename: Graciana
authors.initials: G
authors.lastname: Fuentes-Páez
mesh_terms: D002648:Child; D003094:Collagen / Q000378:metabolism*; D003319:Corneal Stroma / Q000473:pathology*; D003432:Cross-Linking Reagents / Q000627:therapeutic use*; D006801:Humans; D007634:Keratitis / Q000209:etiology*; D007640:Keratoconus / Q000188:drug therapy* / Q000378:metabolism; D008297:Male; D017319:Photosensitizing Agents / Q000627:therapeutic use; D011183:Postoperative Complications; D012256:Riboflavin / Q000627:therapeutic use; D014466:Ultraviolet Rays; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin