Infective Keratitis Following Iontophoresis-assisted Corneal Crosslinking (I-CXL): A Case Report

The Open Ophthalmology Journal 12 Feb 2021 CASE REPORT DOI: 10.2174/1874364102115010001



The standard corneal crosslinking (S- CXL) technique requires corneal epithelial removal, thus increasing the risk of postoperative complications. Newer technique like iontophoresis-assisted corneal crosslinking (I-CXL) with comparable efficacy as S-CXL but without the increased risk of complications associated with corneal epithelium removal is used. However, being a comparatively newer technique, the safety and efficacy of I-CXL have not been fully explored.

Case Description:

Here, we present a case of a 28-year-old woman who presented with infective keratitis in one eye after uneventful bilateral I-CXL for keratoconus. Two days after the procedure, the patient presented with decreased vision and pain in the right eye. Clinical examination revealed ciliary injection and central corneal rounded infiltrates measuring 3.0 mm × 3.0 mm with an overlying epithelial defect. Microbiological studies revealed negative results. Based on clinical examination, the patient was managed successfully with fortified topical antibiotics.


To the best of our knowledge, we report the first documented case of unilateral infective keratitis following bilateral I-CXL. Ophthalmologists should monitor the possible complications post-I-CXL as it might not be as safe as we expect.

Keywords: Corneal crosslinking, Culture-negative keratitis, Infective keratitis, Iontophoresis assisted corneal crosslinking, Efficacy, Ciliary injection.
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