Department of Ophthalmology, Istituto Clnico Humanitas, Rozzano, Milan, Italy.
J Refract Surg. 2011 Dec;27(12):913-5. doi: 10.3928/1081597X-20110812-02. Epub 2011 Aug 19.
To report a case of bilateral, ring-shaped, intrastromal corneal opacities after corneal cross-linking (CXL) for progressive keratoconus.
A 21-year-old man with bilateral, progressive keratoconus underwent CXL with riboflavin 0.1% and ultraviolet A (UVA) light in the right eye and, 6 months later, in the left eye.
One day after CXL, the right eye showed a sharply demarcated white ring in the corneal periphery. The ring involved the superficial stroma at 2 mm from the limbus, extended from 1 to 11 o'clock, and was 1.5-mm wide. Corneal topography showed marked central flattening. Six months after treatment, a residual, faint, ring-shaped opacity remained, with a decrease in corneal ectasia. Cross-linking was then performed in the left eye. Different ultraviolet devices were used in the two eyes. On postoperative day 1, the left eye also showed a white ring of stromal opacity. Scheimpflug imaging showed corneal stromal contraction in the zone of whitening. At final examination, >1 year after surgery, corrected visual acuity was 0.00 logMAR with cylinder of 2.00 diopters in both eyes.
The bilateral intrastromal corneal changes were innocuous in the long-term, with preservation of good visual acuity and successful stabilization of progressive keratoconus.
报告 1 例角膜交联（CXL）治疗进展性圆锥角膜后出现双侧、环形、基质内角膜混浊的病例。
1 名 21 岁男性，双眼进展性圆锥角膜，右眼于 6 个月前接受了含 0.1%核黄素和紫外线 A（UVA）光的 CXL 治疗。
CXL 后 1 天，右眼角膜周边出现明显边界的白色环。该环位于角膜缘 2mm 处的浅层基质内，从 1 点延伸至 11 点，宽 1.5mm。角膜地形图显示明显的中央变平。治疗 6 个月后，残留的、微弱的、环形混浊仍然存在，角膜膨出减少。随后在左眼行交联术。双眼使用了不同的紫外线设备。术后第 1 天，左眼也出现了基质混浊的白色环。Scheimpflug 成像显示在变白区域存在角膜基质收缩。最终随访时，术后 1 年以上，双眼矫正视力均为 0.00 logMAR，柱镜为 2.00 屈光度。
双侧基质内角膜改变在长期内是无害的，保留了良好的视力，并成功稳定了进展性圆锥角膜。
