Paracentral sterile ring infiltrate after corneal crosslinking in a child

Abstract

A child with a paracentral sterile ring infiltrate presenting 3 days after corneal crosslinking (CXL) surgery for keratoconus is reported. The uninterrupted ring-shaped infiltration was seen along the epithelial healing margin in the paracentral cornea. The infiltration was approximately 120 µm deep in the anterior stroma and had sharply defined edges. Swab samples showed negative results. Sterile corneal infiltrate was diagnosed, and the patient was started on topical steroids in addition to the current treatment. The infiltration gradually resolved in the follow-up examinations. Visual loss or permanent corneal haze was not observed at the first month postoperatively. Patients should be carefully evaluated for complications such as sterile infiltrates in the short-term after CXL. An immune response mechanism triggered by the combination of epithelial healing, individual's hypersensitivity, and UV-A irradiation may be etiologically responsible.