Late onset of persistent, deep stromal haze after corneal cross-linking in a patient with keratoconus

Omary, Rawan; Shehadeh-Mashor, Raneen

doi:10.1016/j.jcjo.2016.10.014

Cited by 4 publications

(3 citation statements)

References 9 publications

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“…In this report we present a case of a young patient, who developed visually significant stromal haze after CXL in the late postoperative period. Contrary to our case, early onset clinically non-significant corneal haze is very common after CXL and considered by some authors to be part of the natural history of the condition after the procedure 7 , 14 …”

Section: Discussioncontrasting

confidence: 86%

“…As far as late-onset corneal haze after CXL, Omary R et al reported a case of a clinically significant corneal haze that appeared 11 months after CXL and persisted with only slow and incomplete clearing with topical steroid treatment 14 . In our patient, clinically significant corneal haze appeared in the late postoperative period, 18 months after CXL, and treated successfully with topical steroids.…”

Section: Discussionsupporting

confidence: 52%

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Late onset corneal haze after corneal cross-linking for progressive keratoconus

Peponis

Kontomichos

Chatziralli

et al. 2019

American Journal of Ophthalmology Case Reports

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PurposeTo present the case of a patient that underwent corneal crosslinking for progressive keratoconus and 18 months later revealed clinically significant corneal stromal haze.ObservationsA 20-year-old male presented with progressive visual loss OU for the past few years. His corrected distance visual acuity (CDVA) OD was 20/30 (−2.75 -1.75 @55) and OS 20/30 (−0.50 -1.75@110). Corneal topography revealed keratoconus OU and the patient underwent corneal crosslinking according to the Dresden Protocol. The postoperative regimen included combined tobramycin and dexamethasone qid along with lubrication until epithelium healed and then fluorometholone qid with weekly tapering. At 3 months postoperatively, his topography was stable and his corrected distance visual acuity (CDVA) was 20/25 OU. On slit lamp examination, only clinically insignificant stromal haze was observed. At 18 months postoperatively, the patient reported vision deterioration. On examination his CDVA was 20/25 in right eye, and 20/40 in his left eye. Deep stromal haze was revealed in his central cornea, more dense in his left eye. Corneal topography was stable and the CDVA loss was attributed to the notable deep stromal haze. The patient was treated with dexamethasone qid with biweekly tapering. 18 months after corneal crosslinking, the patient demonstrated clinically significant stromal haze, most prominent OS. He was treated with dexamethasone qid. One month later his CDVA OS gradually improved to 20/25, and stromal haze was still noted but less dense.Conclusions and importanceLate-onset deep corneal haze is a possible complication of corneal crosslinking in keratoconic patients.

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Section: Discussioncontrasting

confidence: 86%

Section: Discussionsupporting

confidence: 52%

Late onset corneal haze after corneal cross-linking for progressive keratoconus

Peponis

Kontomichos

Chatziralli

et al. 2019

American Journal of Ophthalmology Case Reports

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“…It is established that corneal haze first appears at 1 month after CXL, plateaus between the 3 rd and 6 th month after which significant regression begins and extends until 1 year after the procedure. [ 11 , 12 ] Our study found that persistent corneal haze beyond a year after cross-linking can be reduced with topical steroids with steeper and thinner corneas showing greater response. A prospective study done in 2009 by Koller et al .…”

Section: Discussionmentioning

confidence: 69%

Corneal Haze Secondary to Corneal Collagen Cross-linking in Keratoconus Patients: Treatment and Outcomes

Sayegh,

Sammouh,

Ayash

et al. 2022

Middle East African Journal of Ophthalmology

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PURPOSE: The purpose of this study was to evaluate the outcome of patients presenting with mild-to-moderate corneal haze after undergoing corneal collagen cross-linking (CXL) for keratoconus (KCN) and their response to a proposed standardized topical steroid-based treatment. METHODS: This study included 19 eyes of 14 patients presenting with corneal haze after undergoing CXL for KCN. Corrected distance visual acuity, corneal thickness and Kmax values by Pentacam® Scheimpflug tomography, as well as subjective corneal haze changes were evaluated before and after a topical steroid- and cyclosporine-based treatment. RESULTS: Visual acuity improved after the completion of the treatment by 0.043 logMAR (P = 0.017) and Kmax values decreased by 1.17D (P = 0.0024), while the corneal thinnest pachymetry remained stable. Data collected from the examiner’s slit-lamp examination description revealed that seven eyes had a decrease in haze compared to 12 eyes with stable or no changes in the haze. CONCLUSION: Our findings suggest an improvement in visual acuity and possible corneal flattening with decreasing Kmax after the completion of topical steroids with taper course treatment in patients suffering from corneal haze post-CXL. This paper also highlights the importance of postcross-linking anti-inflammatory treatment and close follow-up.

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Corneal Laser Surgery for Keratoconus

Awwad¹,

Izquierdo²

2023

Keratoconus

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Late onset of persistent, deep stromal haze after corneal cross-linking in a patient with keratoconus

Cited by 4 publications

References 9 publications

Late onset corneal haze after corneal cross-linking for progressive keratoconus

Late onset corneal haze after corneal cross-linking for progressive keratoconus

Corneal Haze Secondary to Corneal Collagen Cross-linking in Keratoconus Patients: Treatment and Outcomes

Corneal Laser Surgery for Keratoconus

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