Evaluation Of The Efficacy Of High Fluence Corneal Collagen Cross Linking With Three Different Uva Levels In Fusarium Keratitis In Rabbits
Published 2023 - 41st Congress of the ESCRS
Reference: FP06.11 | Type: Free paper | DOI: 10.82333/p3s1-8693
Authors: Ramy Awad Mohamed Elbassiouny* 1 , Ahmed Elmassry 2 , Alaa Ghaith 2 , Khaled Awad 1 , Manal Baddour 3 , Eman Sheta 4 , Farhad Hafezi 5
1Ophthalmology,Alexandria Ophthalmology Hospital,Alexandria,Egypt, 2Ophthalmology,Faculty of Medicine, Alexandria University,Alexandria,Egypt, 3Microbiology and immunology,Faculty of Medicine, Alexandria University,Alexandria,Egypt, 4Pathology,Faculty of Medicine, Alexandria University,Alexandria,Egypt, 5Ophthalmology,ELZA Institute,Dietikon,Switzerland
Purpose
The aim of the study is to evaluate high fluence Corneal Collagen Cross-linking efficacy and to compare three UVA fluence levels and with topical voriconazole in fusarium fungal keratitis induced in rabbits eye model.
Setting
This wasan interventional study conducted in the animal lab of Medical Research Institute, Alexandria University, Egypt, in collaboration with Ophthalmology, Microbiology and pathology departments of Alexandria Faculty of Medicine, Alexandria, Egypt. The study was approved by local animal research committee at Alexandria University, Alexandria, Egypt (No. 0201334- 03/2020).
Methods
This is an interventional experimental study including both eyes of 20 male rabbits (40 eyes). Fusarium Solani was intrastromal injected into the cornea to induce keratitis. The rabbits were then divided into five groups (8 eyes for each) from which group A recieved no treatment and left as control. Group B received topical Voriconazole drops every hour. Group C, D and E received single PACK-CXL session with total fluence levels of 7.2, 10.0 and 15.0 J/cm2 for each respectively. Daily clinical examination was recorded. On day 10, all corneas were removed for microbiology and histopathology evaluation.
Results
The mean clinical signs score eyes treated with high fluence PACK-CXL showed evident clinical improvement from fourth to tenth day of treatment. This improvement was equivalent to that of Voriconazole treatment. The results showed better improvement with increasing the UVA total fluence levels but this difference was not statistically significant (P < 0.05). Similarly, the median CFU/ml declined on increasing UVA fluence but with no statistically significant values. Histopathological examination revealed better improvement of inflammatory signs on higher fluence levels compared to lower ones.
Conclusions
High intensity PACK-CXL (30 mW/cm2) was as effective as Voriconazole in the treatment of fungal keratitis in rabbits. Increasing the fluence of UVA was associated with slightly better clinical outcomes with no added risks. More clinical studies are needed to confirm these results.