Sterile keratitis following collagen crosslinking

Purpose: to report a keratoconic eye that developed severe sterile keratitis and corneal scar after collagen crosslinking necessitating corneal transplantation. case report: a 26?year?old man with progressive keratoconus underwent collagen crosslinking and presented with severe keratitis 72 hours after the procedure. the initial impression was infectious corneal ulcer and a fortified antibiotic regimen was administered. however,the clinical course and confocal microscopy results prompted a diagnosis of sterile keratitis. the eye developed severe corneal scars leading to reduced visual acuity and necessitating corneal transplantation. conclusion: sterile keratitis may develop after collagen crosslinking resulting in profound visual loss leading to corneal transplantation.