To report efficiency of intrastromal Vancomycin injection in a case of infectious crystalline keratopathy which was resistant to topical antibiotic therapyTo the best of our knowledge,this is the first time that intrastromal vancomycin was used to treat staphylococcal crystalline keratopathy after corneal cross linking.

In this report, we present a patient who developed an infection crystalline keratopathy following a corneal cross linking due to keratoconus. Smear and culture revealed staphylococcus areus. We started fortified vancomycin and the consequent response to this treatment was partial and unsatisfactory. Superficial keratectomy was done according to raised corneal infiltration.Intrastromal vancomycin was injected for patient following SK in the dosage of 0.1 mg per ml around the site of ICK.

Dramatic response was achieved. The patient’s best corrected visual acuity was 20/40 2 weeks after injection. Corneal infiltration and other signs and symptoms resolved.

Staphylococcus areus can be a causative organism of infectious crystalline keratopathy and can arise in a post corneal cross linking patient.Our case demonstrates the putative benefit of intrastromal antibiotics as an adjunct to topical therapy in resistant cases.