Subclinical inflammatory response after accelerated corneal cross-linking

Background:To evaluate the inflammatory response after accelerated collagen cross-linking(CXL)in eyes with keratoconus.Methods:Consecutive eyes with keratoconus undergoing CXL surgery were included in this nonrandomized interventional study.Aqueous flare was measured pre-and post-operatively with a laser flare photometer at 1 week,1,3 and 6 months after CXL.Results:Sixty eyes of 60 patients were entered into the study.Before CXL,the mean flare value was4.5 photons per millisecond(ph/ms).The flare values observed at week 1(7.1 ph/ms;P=0.008),month 1(6.5 ph/ms;P=0.04),month 3(6.7 ph/ms;P=0.004)and month 6(6.7 ph/ms;P=0.004)were significantly higher compared to baseline.Flare values were not significantly different from week 1 up to 6 months after CXL(P=0.930).No statistically significant correlation was detected between the amount of inflammation and keratometric indices.Conclusions:Accelerated CXL in patients with keratoconus may cause a subclinical inflammatory response which is evident as slight but rather long-lasting rise of aqueous flare.