NOV 06, 2017
Prevention and Management of Complications Following Corneal Crosslinking
Refractive Subspecialty Day 2016
Refractive Mgmt/Intervention
The published complication rates (≥ 2 Snellen lines visual acuity loss) range from 0% (O’Brart, 2013) to 13.7% (Hashemi, 2013). Our personal experience based on the Dresden protocol indicates a complication rate of < 1%. Early postoperative complications include sterile infiltrates (7%), stromal scars (3%), and persisting corneal erosion (2%). Sterile infiltrates can be unchanged with topical corticosteroids 3 times/day. Stromal scars fade, and a flattening effect reduces significantly within the first year after surgery. Persisting erosion needs to be treated by bandage contact lenses. Rare complications reported in the literature include endothelial damage and reactivation of herpes keratitis. Endothelial damage may occur if the thickness of the cornea is reduced (due to dextrane) to less than 400 microns. Reactivation of herpes may be avoided by adding systemic valacyclovir in suspicious cases.