title: In Situ Corneal Cross-Linking for Recurrent Corneal Melting After Boston Type 1 Keratoprosthesis.
abstract: OBJECTIVE
  To present a new treatment modality for recurrent corneal melting in a patient with a Boston type I keratoprosthesis (B-KPro) including in situ corneal cross-linking (CXL) and lamellar keratoplasty (LKP) as combined treatment.
  
  
  METHODS
  Case report.
  
  
  RESULTS
  Our report concerns a 27-year-old man whose case history involved a severe chemical burn of his left eye. After failed penetrating keratoplasty and limbal stem cell transplantation, the patient underwent B-KPro implantation. Starting 1 month after surgery, recurrent corneal melting around the B-KPro developed, which was eventually treated by combining LKP, amniotic membrane transplantation, and in situ CXL. Optical coherence tomography imaging and follow-up for 12 months showed stable corneal healing without new melting or erosion. The ultraviolet A treatment did not seem to damage the material of the B-KPro.
  
  
  CONCLUSIONS
  In situ CXL using riboflavin and ultraviolet A light combined with LKP and amniotic membrane transplantation can be an effective management option to treat recurrent corneal melting after B-KPro implantation.
authors.affiliation: *Department of Ophthalmology, Semmelweis University, Budapest, Hungary; †Department of Ophthalmology, University of Cologne, Cologne, Germany; and ‡Department of Ophthalmology, Saarland University Medical Center, Homburg, Saar, Germany.
authors.forename: Gábor
authors.initials: G
authors.lastname: Tóth
authors.forename: Franziska
authors.initials: F
authors.lastname: Bucher
authors.forename: Sebastian
authors.initials: S
authors.lastname: Siebelmann
authors.forename: Björn
authors.initials: B
authors.lastname: Bachmann
authors.forename: Manuel
authors.initials: M
authors.lastname: Hermann
authors.forename: Nóra
authors.initials: N
authors.lastname: Szentmáry
authors.forename: Zoltán Zsolt
authors.initials: ZZ
authors.lastname: Nagy
authors.forename: Claus
authors.initials: C
authors.lastname: Cursiefen
mesh_terms: D000328:Adult; D000650:Amnion / Q000637:transplantation*; D001705:Bioprosthesis / Q000009:adverse effects*; D002057:Burns, Chemical / Q000601:surgery; D003094:Collagen / Q000378:metabolism; D003316:Corneal Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D003319:Corneal Stroma / Q000378:metabolism; D016039:Corneal Transplantation; D003432:Cross-Linking Reagents; D005126:Eye Burns / Q000139:chemically induced; D006801:Humans; D008297:Male; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D012008:Recurrence; D012256:Riboflavin / Q000627:therapeutic use; D014466:Ultraviolet Rays
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin