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First Author: I.Bahar ISRAEL
Co Author(s): K. Tal O. Gal-Or S. Goldshtein A. Zahavi O. Rock I. Kaiserman
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To evaluate the efficacy of primary collagen cross-linking (CXL) therapy for Staphylococcus aureus induced corneal ulcer ,in a rabbit model
Felsenstein Research Institute, Rabin Medical Center.
The right eye of 40 New Zealand white rabbits was inoculated with Staphylococcus aureus to induce staph aureus ulcer in the center of the cornea. Rabbits were randomly assigned into 4 groups: Group A was treated with topical antibiotics (cefazolin 50 mg/ml, garamycin 14 mg/ml drops and chloramphenicol 5% ointment q 2 hr); Group B was treated with CXL only; Group C was treated with CXL combined with topical antibiotics (cefazolin 50 mg/ml, garamycin 14 mg/ml drops and chloramphenicol 5% ointment qid) ; Group D received no treatment and served as a control. Ulcer was induced on day 1, measured on day 5 and then treated according to the group assignment. Follow up examination was performed using biomicroscopy on day 5 and every week up to one month of follow up. Main outcome measures included corneal ulcer or scar diameter, time to full recovery, time to full epithelization, and change in corneal thickness measurements
All animals developed corneal ulcers. Group B had significantly larger induced corneal ulcer on day 5 (P = 0.03) but achieved the most significant reduction of ulcer/scarred area (P=0.002) after 1 month of therapy; Group C showed the shortest ulcer healing time (16.7 days) followed by group A (19.7 days) , group D (21.8 days) and group B (23.7days); Group C also demonstrated the smallest ulcer size at day 30 (11.2 mm2, P=0.01) followed by group A (13 mm2, P=0.04).
Primary corneal CXL therapy combined with topical antibiotics seem to be effective in shortening ulcer healing time and ended up with the smallest corneal scar in our rabbit model. Further investigation of this mode of treatment as the primary treatment for infectious keratitis is mandatory.