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A South Indian tertiary-center study examined infectious keratitis occurring after corneal collagen cross-linking (CXL) over a 10-year period. Among 3,842 in-house CXL procedures, 11 eyes developed post-CXL infectious keratitis, indicating a low incidence but clinically significant complication. The microbiological profile included bacterial organisms as well as fungal infections, and many affected eyes presented very early after treatment. The study is particularly relevant to high-volume corneal practices because it turns a rare complication into a practical postoperative surveillance issue. CXL involves epithelial disruption in many protocols, and the immediate postoperative period is therefore critical for recognizing infection, delayed epithelial healing, or stromal inflammation. The publication highlights the importance of patient counseling, sterile technique, appropriate antimicrobial prophylaxis according to local practice, and prompt reassessment when pain, infiltrate, hypopyon, or worsening vision occurs. The findings also reinforce that apparent post-CXL haze should not automatically be assumed to be a sterile phenomenon. Early differentiation between expected healing, sterile inflammation, and infectious keratitis can change the clinical trajectory and reduce the risk of corneal melt, scarring, or emergency therapeutic transplantation.
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A South Indian tertiary-center study examined infectious keratitis occurring after corneal collagen cross-linking (CXL) over a 10-year period. Among 3,842 in-house CXL procedures, 11 eyes developed post-CXL infectious keratitis, indicating a low incidence but clinically significant complication. The microbiological profile included bacterial organisms as well as fungal infections, and many affected eyes presented very early after treatment. The study is particularly relevant to high-volume corneal practices because it turns a rare complication into a practical postoperative surveillance issue. CXL involves epithelial disruption in many protocols, and the immediate postoperative period is therefore critical for recognizing infection, delayed epithelial healing, or stromal inflammation. The publication highlights the importance of patient counseling, sterile technique, appropriate antimicrobial prophylaxis according to local practice, and prompt reassessment when pain, infiltrate, hypopyon, or worsening vision occurs. The findings also reinforce that apparent post-CXL haze should not automatically be assumed to be a sterile phenomenon. Early differentiation between expected healing, sterile inflammation, and infectious keratitis can change the clinical trajectory and reduce the risk of corneal melt, scarring, or emergency therapeutic transplantation.
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