UVA/Riboflavin Cross-Linking as an Alternative Treatment for Therapeutic Keratoplasty in Corneal Melting

Purpose: To demonstrate the effectiveness of UVA/riboflavin cross-linking (CXL) in the treatment of therapy resistant corneal melting of different etiology. Methods: This paper describes a series of four cases presenting severe ulcerative keratitis with infectious and noninfectious causes. In spite of intensive medical treatment, corneal melting did develop in all four eyes. CXL was performed to avoid imminent corneal perforation. Results: After CXL, there was a rapid improvement in two eyes which healed completely within a month. In the other two eyes, an emergency keratoplasty had to be performed. Conclusion: This case series highlights the effectiveness of CXL in the treatment of corneal melting as an addition to our current therapeutic armamentarium. Improvement can be expected in a few days after treatment. CXL can be considered as an adjunct therapy as soon as melting appears in severe corneal ulcers not responding to conventional, intensive treatment.