Sadalla Amin Ghanem Eye Hospital, Joinville, Santa Catarina, Brazil.
Cornea. 2012 Jun;31(6):702-5. doi: 10.1097/ICO.0b013e318226da53.
To present 7 cases of peripheral sterile corneal infiltrates that occurred after corneal cross-linking (CXL) for progressive keratectasia.
Seven patients who had their progressive keratoconus documented underwent corneal deepithelization and subsequently CXL, which was performed with the application of 0.1% riboflavin with 20% dextran, and exposure to UVA light (370 nm, 2.9-3.1 mW/cm(2)) for 30 minutes.
Nearly a week after the procedure, the patients presented with peripheral stromal infiltrates. The ring-like infiltrates were superficial and were present at the 9.0-mm zone. Sterile infiltration was diagnosed. Patients were treated with topical corticosteroids, and complete resolution was achieved after a few weeks of treatment.
We hypothesize that the phototoxic effect on the corneal stroma may be the main mechanism that triggers these infiltrates. Alternatively, alterations in antigenicity that occur in native proteins after CXL could result in patients recognizing the proteins as nonself and mounting immune responses.
报告 7 例角膜交联（CXL）治疗进行性圆锥角膜后发生的外周无菌性角膜浸润。
7 例进行性圆锥角膜患者接受角膜去上皮化，随后进行 CXL。应用 0.1%核黄素加 20%葡聚糖，暴露于 UVA 光（370nm，2.9-3.1mW/cm2）30 分钟。
术后近一周，患者出现周边基质浸润。环状浸润为浅层，位于 9.0mm 区。诊断为无菌性浸润。患者接受局部皮质类固醇治疗，治疗数周后完全缓解。
我们假设光毒性作用于角膜基质可能是引发这些浸润的主要机制。或者，CXL 后天然蛋白的抗原性改变可能导致患者将这些蛋白识别为非自身，并产生免疫反应。
