A sterile corneal perforation in a postpartum lactating mother after 10 years of CXL: A case report and review of literature

Abstract

To report a case of corneal perforation following injury with a child’s finger in a postpartum lactating mother in a corneal collagen cross-linkage with 1% riboflavin (CXL)-treated eye. A 28-year-old-female presented to us with acute and severe ocular pain in the right eye to the emergency department. She gave history of CXL done 10 years back, and examination revealed central corneal perforation with a flat anterior chamber. We managed the case successfully with penetrating keratoplasty, followed by a glaucoma tube procedure for secondary glaucoma. CXL is the standard treatment for progressive keratoconus, and its long-term safety is well known. Corneal perforation as an adverse event following CXL has also been noted in a few case reports. This case emphasizes the need for close follow-up with serials documentation of corneal thickness and prompt intervention.