Wessely-type immune ring following collagen cross-linking

BMJ Case Rep. 2024 Dec 5;17(12):e261923. doi: 10.1136/bcr-2024-261923.

Abstract

A woman in her early 20s with progressive keratoconus underwent corneal collagen cross-linking using the sub400 protocol. The central 5.5 mm of the epithelium was removed after the application of 20% alcohol. Topical riboflavin 0.1% was applied every 3 min for 30 min and then irradiated with UV-A light (irradiance of 3 mW/cm2 for 16 min). At the end of the procedure, a therapeutic contact lens was placed and ofloxacin 0.3% (4 times daily), dexamethasone 0.1% (4 times daily) and lubricant (hourly) drops were prescribed.Two days after the procedure, the patient presented with a painless red eye. A 360° peripheral ring-like infiltrate was observed in the 5.5 mm zone, consistent with a sterile infiltrate. Dexamethasone 0.1% drops were prescribed and tapered for 1 month. Although the infiltrate gradually decreased under corticosteroid therapy, the patient's condition worsened after discontinuation of treatment. Treatment was resumed and complete recovery was observed 4 months later.

Keywords: Eye; Immunological products and vaccines.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Collagen*
  • Cross-Linking Reagents / therapeutic use
  • Dexamethasone / administration & dosage
  • Dexamethasone / therapeutic use
  • Female
  • Humans
  • Keratoconus* / drug therapy
  • Photosensitizing Agents / therapeutic use
  • Riboflavin* / therapeutic use
  • Ultraviolet Rays / adverse effects
  • Young Adult

Substances

  • Collagen
  • Riboflavin
  • Cross-Linking Reagents
  • Dexamethasone
  • Photosensitizing Agents