CENTRAL TOXIC KERATOPATHY FOLLOWING EPI-OFF CORNEAL CROSS-LINKING: A CASE SERIES FROM AN EXTERNAL TERTIARY REFERRAL CENTER
Published 2025 - 29th ESCRS Winter Meeting
Reference: PO090 | Type: Presented Poster & Poster | DOI: 10.82333/8qe0-q705
Authors: M. Enes Aydemir 1 , Emilio A. Torres-Netto 1 , Mark Hillen 1 , Frank Blaser 2 , Zisis Gatzioufas 3 , Shady Awwad 4 , Farhad Hafezi* 5
1ELZA Institute,Zurich,Switzerland, 2Department of Ophthalmology,University Hospital Zurich,Zurich,Switzerland, 3Department of Ophthalmology,University Hospital of Basel,Basel,Switzerland, 4Department of Ophthalmology,American University of Beirut Medical Center,Beiruit,Lebanon, 5ELZA Institute,Zurich,Switzerland;Faculty of Medicine,University of Geneva,Geneva,Switzerland;Department of Ophthalmology,Wenzhou Medical University,Wenzhou,China;National Eye Institute of Uzbekistan,Tashkent,Uzbekistan;Department of Ophthalmology,New York University Grossman School of Medicine,New York,United States;Department of Ophthalmology,University of Southern California,Los Angeles,United States
Purpose
To report a case series of central toxic keratopathy (CTK) in patients who underwent epi-off corneal cross-linking (CXL) at an external tertiary referral center for ophthalmology in Switzerland.
Setting
External tertiary referring center.
Methods
This series includes 15 eyes from 11 patients who developed CTK following epi-off CXL procedures performed between 2011 and 2016 at the same external tertiary referral center. The patients presented to our clinic for further evaluation. Ophthalmic examinations were performed, including slit lamp examination, corrected distance visual acuity (CDVA) testing, and comprehensive corneal evaluations with topography, tomography, biomechanical assessments, and high-resolution anterior segment optical coherence tomography (AS-OCT).
Results
AS-OCT imaging revealed extensive scarring and significant thinning in the anterior and deep corneal stroma in 10 eyes. Distinct corneal haze was noted in five eyes.
Conclusion
While epi-off CXL is a well-established treatment with two decades of research, complications such as CTK can still occur. The increasing use of less invasive epi-on CXL may reduce the incidence of CTK, but surgeons should remain aware of this potential complication following CXL.