Table 2.
Review on similar reported reports regarding post CXL corneal edema
Number [Ref.] | Age Sex Eye |
Elapsed time after CXL to presentation | Preoperative VA, Keratometry, Pachymetry | Riboflavin usage | Examination | Investigation | Outcome |
---|---|---|---|---|---|---|---|
1 [8] |
18 M OD |
20 days |
20/20 50 514 |
Riboflavin (0.1%) in dextran 20% every 2 min for 30 min which continued every 2 min during irradiation |
-Epithelial and stromal edema with Descemet folds -Pigmented KPs -Dilated and fixed pupil |
-Pachymetry: thickness more than 1000 mm -Negative PCR of aqueous fluid -ECD: 1571 |
-Performing of PK 6 months later due to epithelial bullae and severe corneal edema - BCVA of 20/60 three months after PK |
2 [10] |
37 M OS |
1 month (start of symptoms was since the first postoperative day) |
20/60 57.8 448 |
0.1% riboflavin every 5 min for 25 min which continued every 5 min during irradiation |
-Central corneal edema with severe stromal haze -No Descemet rupture |
-ASOCT: thickness of 844 mm -Specular microscopy: 1776 (at the 6-month visit) |
-Resolved edema in 3 months -Resolved stromal haze in 6 months -A residual ring-shaped corneal scar -BCVA of CF at 3 m |
3 [9] |
24 F OD |
3 days |
20/40 53.4 488 |
0.1% riboflavin with 20% dextran every 2 min for 30 min which substituted with 0.1% hypotonic riboflavin every 2 min during irradiation to swell the cornea to at least 400 mm | -Ring-shaped endothelial infiltrates and localized corneal edema in the inferior paracentral of cornea | -ECD of both eyes were comparable after resolving of the problem (2732 vs. 2707) |
-Resolved after 1 week -BCVA of 20/25 (lens-fitted) |
4 [11] |
Average of age: 22 ± 5 7 M and 3 F (10 patients) |
First day (in all cases) |
Median logMAR of BCVA: 0.00 ± 0.08 Median of maximum keratometry: 57.4 ± 2.90 Mean of pachymetry: 472.6 ± 17.5 |
Isotonic riboflavin 0.1% every 2 min for 30 min which continued every 3 min during irradiation |
-Corneal edema and anterior chamber inflammation which increased for 2 to 3 weeks –No Descemet membrane rupture -No lens opacities -Corneal vascularization (2 eyes) -Iris atrophy (6 eyes) -Pigment dispersion (5 eyes) -CED for more than 6 days (3 eyes) -Infectious keratitis (1 eye) |
N/A |
-Median logMAR of BCVA: 0.60 ± 0.30 -Corneal edema improved in 4 patients and resolved in 1 patient. − 2 patients underwent PK at 8 and 13 months after CXL |
F Female, M Male, OD Right eye, OS Left eye, KP Keratic precipitate, PCR Polymerase chain reaction, ECD Endothelial cell density; PK Penetrating keratoplasty, BCVA Best-corrected visual acuity, ASOCT Anterior segment optical coherency tomography, CF Counting fingers, CED Corneal epithelial defect)