J Korean Ophthalmol Soc.  2020 Feb;61(2):200-204. 10.3341/jkos.2020.61.2.200.

Corneal Collagen Cross-linking for Corneal Ulcer from Moraxella Group

• Woo SE
• Lee SH

• KMID: 2470743
• DOI: http://doi.org/10.3341/jkos.2020.61.2.200

Abstract

PURPOSE
To report a case of corneal collagen cross-linking for corneal ulcer caused by the Moraxella group.
CASE SUMMARY
A 77-year-old male had decreased visual acuity for several days in his right eye. The patient showed severe stromal ring infiltrates with a corneal epithelial defect measuring (5.0 × 7.0 mm), a corneal endothelial plaque, and a hypopyon measuring less than 1.0 mm in height in the anterior chamber of the right eye. There was no abnormal finding in the right eye using B-scan ultrasonography. Before starting treatment, a corneal culture was conducted. The culture tests showed the presence of the Moraxella group. Because the patient was diagnosed with a corneal ulcer caused by the Moraxella group, corneal collagen cross-linking (CXL) was performed. The antimicrobial susceptibility test confirmed that this Moraxella group was sensitive to ceftazidime, so the patient was treated with 5% ceftazidime eye drops and 0.5% moxifloxacin eye drops every 2 hours for 9 months after corneal collagen CXL. The uncorrected visual acuity was 0.1 in the right eye, and there was almost no corneal stromal melting on anterior segment optical coherence tomography.
CONCLUSIONS
This is the first known case of a corneal ulcer, in the Republic of Korea, caused by the Moraxella group and treated with corneal collagen CXL. Corneal collagen CXL should be considered as a surgical treatment for patients who have an impending corneal perforation due to a corneal ulcer because it is a simple procedure and causes fewer serious complications than other treatments.

Keyword

Cornea; Corneal collagen cross-linking; Moraxella

MeSH Terms

Aged
Anterior Chamber
Ceftazidime
Collagen*
Cornea
Corneal Perforation
Corneal Ulcer*
Freezing
Humans
Male
Moraxella*
Ophthalmic Solutions
Republic of Korea
Tomography, Optical Coherence
Ultrasonography
Visual Acuity
Ceftazidime
Collagen
Ophthalmic Solutions

Figure

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  Figure 1 Anterior segment photograph of the right eye at presentation. Stromal ring infiltrate (white arrow), endothelial plaque (yellow arrow) and hypopyon (black arrow) were revealed.

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  Figure 2 Anterior segment photograph of the right eye at 1 month after corneal collagen cross-linking. Corneal stromal opacity (white arrow) and peripheral corneal neovascularization (yellow arrow) were revealed.

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  Figure 3 Anterior segment photograph of the right eye at 9 months after corneal collagen cross-linking. The patient showed dramatic improvement, with only corneal opacity (arrow).

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  Figure 4 Anterior segment optical coherence tomography (A) and anterior photography (B) of the right eye at 9 months after corneal collagen cross-linking. There was focal corneal stromal thickness thinning and corresponding increase in corneal epithelial thickness at the central and temporal region of cornea on anterior segment optical coherence tomography.

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