Corneal collagen cross-linking has potential as an effective treatment for superficial microbial keratitis and as an aide for the treatment of non-resolving microbial keratitis, according to a study.
In the study of 15 eyes, nine eyes had bacterial keratitis and six had fungal keratitis, all culture-proven and all considered unresolved after 2 weeks of topical atropine, antibacterials and antifungals.
Because an existing epithelium defect already existed overlying the affected area in all patients, epithelium was not removed before cross-linking. Patients received a total dose of 5.4 J/cm of UV illumination over 30 minutes. Preoperative topical medications were continued but no anti-inflammatories were prescribed after the procedure.
After treatment , bacterial keratitis resolved in six patients and fungal keratitis resolved in three patients. Mean time for epithelial healing was 21.3 days and for corneal infiltrate resolution was 33.44 days.
Patients who underwent corneal collagen cross-linking reported feeling less pain after the first preoperative day.
“Further studies are required to streamline the indications, protocol and safety profile of CXL [corneal collagen cross-linking] in the management of microbial keratitis,” the study authors said.
Disclosure: The study authors have no relevant financial interests.