A recent study found that accelerated photoactivated chromophore corneal collagen crosslinking (PACK-CXL) may be effective as an alternate treatment for moderate-sized infectious keratitis resistant to other therapies.
Researchers looked at 20 patients hospitalized for moderate-sized therapy-resistant bacterial corneal ulcers. In addition to standard antimicrobial treatment, the patients were treated with hypo-osmolar 0.1% riboflavin solution and ultraviolet A irradiation, each for three minutes at 30mW/cm2.
Results show a median ulcer size of 3mm after treatment, a median re-epithelialization time period of 6.5 days and a mean overall hospital stay of 8.5 ± 4.5 days. Additionally, patients did not show any adverse treatment effects on the corneal stroma or limbus. One patient (5% of the study group) required tectonic keratoplasty.
“Our results suggest that accelerated PACK-CXL may provide an antimicrobial effect similar to the one, low-intensity, slow setting (30 minutes at 3mW/cm2) and may be used as additional treatment in moderate-sized, therapy-resistant infectious keratitis,” the study concluded. While promising, further research is needed to confirm these findings.
|Knyazer B, Krakauer Y, Baumfeld Y, et al. Accelerated corneal cross-linking with photoactivated chromophore for moderate therapy-resistant infectious keratitis. Cornea. 2018;37(4):528-31.|