Corneal Infiltrates After Corneal Collagen Cross-Linking

To present a case of advancing keratoconus treated with corneal collagen cross-linking (CXL) with ultraviolet A (UVA) light and riboflavin complicated with sterile infiltrates.The patient's cornea was de-epithelialized and CXL was performed with application of riboflavin and exposure to UVA light (370 nm, 3 mW/cm2) for 30 minutes.Early in the postoperative period, the patient presented with 11 deep stromal infiltrates of 1 to 2 mm with clear demarked edges in a circle near the limbus with some clear cornea. Corneal cultures were negative. Treatment consisted of antibiotic ofloxacin and tobramycin four times daily, and dexamethasone drops six times daily. After 2 months, scars remained evident.This complication has not been reported previously and may be an individual hypersensitivity reaction to the riboflavin or UVA light in the anterior stroma.