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Accelerated PACK-CXL as a first-line and sole treatment in contact lens-related corneal infiltrates of bacterial and fungal origin

Poster Details

First Author: D.Tabibian SWITZERLAND

Co Author(s):    O. Richoz   F. Hafezi                 

Abstract Details

Purpose:

To report on the effect of accelerated PACK-CXL as a first-line and sole treatment in contact lens-related corneal infiltrates of bacterial and fungal origin.

Setting:

Ophthalmology Department, Geneva University Hospitals,Switzerland

Methods:

Five consecutive patients presenting with a contact lens-related corneal infiltrate were managed with corneal swabs, anterior segment photography, topographical examination and corneal optical coherence tomography on the affected eye after the patient signed an informed consent to participate in our study. The epithelium was removed over the infiltrate and with a diameter of 1mm around the infiltrate. Hypoosmolaric riboflavin solution was instilled for 30 minutes, followed by UV-A irradiation at 365 nm and 9 mW/cm2 for 10 minutes. Postoperatively, only vitamin A ointment was applied, and the patient was closely followed every 24 hours until complete healing of the epithelium.

Results:

All patients showed complete epithelial healing at day 3. None of them required topical antibiotics postoperatively. At day 3, anterior segment OCT showed reduction of the infiltrate and reduction of conjunctival hyperemia. In three patients, no pathogen could be identified; one patient presented a bacterial infection (pseudomonas aeruginosa), another one a fungal infection (aerobasidium pullulans).

Conclusions:

Accelerated PACK-CXL might be an effective first-line treatment for fungal and bacterial infiltrates in contact lens-related infections. Further clinical studies are needed to compare its efficiency to standard antibiotics and antifungal regimen as first-line treatment.

Financial Disclosure:

One or more of the authors has significant investment interest in a company producing, developing or supplying product or procedure presented

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