Investigators continue to find new applications for corneal collagen crosslinking (CXL) in the management of infectious corneal wound healing. New research out of Turkey shows that CXL with photoactivated riboflavin (PACK-CXL) can treat certain kinds of fungal keratitis infections.

The investigators, who published their findings in the June issue of Acta Ophthalmaologica, examined 64 rabbit corneas infected with Fusarium solani or Candida albicans and divided them into four groups: a control group, a PACK-CXL treated group, a voriconazole-alone group and a PACK-CXL combined with voriconazole group. Then, the researchers tested the amount of colony-forming units (CFUs) of reproduced microorganisms in each group. In both PACK-CXL groups, fewer hyphae and non-specific stromal changes were observed. But the group that combined the voriconazole with PACK-CXL did particularly well, maintaining the original number (100CFU/ml) applied. The PACK‐CXL-alone group had 150CFU/ml and the voriconazole-alone group had 200CFU/ml. For perspective on how effective that is, consider the control group’s 4,000CFU/ml.

The results, the study concludes, make the case for a combined PACK-CXL and voriconazole treatment of fungal keratitis at the early stage of the disease.

Özdemir H, Kalkancı A, Bilgihan K, et al. Comparison of corneal collagen cross-linking (PACK-CXL) and voriconazole treatments in experimental fungal keratitis. Acta Ophthalmol. June 4, 2018. [Epub ahead of print].