CORNEAL COLLAGEN CROSSLINKING FOR THE TREATMENT OF MICROBIAL KERATITIS

aimed to assess the efficacy and safety of corneal collagen cross-linking (CXL) in the management of infectious keratitis

This study is prospective Interventional Non-comparative case series

 Anesthetize the cornea with topical tetracaine of 0.1% drops 5 min before and just before the procedure. Eyelashes were isolated by a drape and a speculum. An 8 mm zone of corneal epit- helium including all microbial infiltrates was removed using a thin blunt metal (Hockey knife), and then 0.1% riboflavin in dextran 500 20% drops were adminis- tered every three minutes for 30 minutes. Then cornea was exposed to UV-A rays (365 nm) in an optical zone of 8 mm for 30 minutes with an irradiance of 3 mW/ cm2. During the procedure, moistened the cornea every 5 minutes with 0.1% ribofla- vin and tetracaine drops. After irradiation, a therapeutic soft contact lens was used and removed one day after placement

 Baseline visual acuity was in form of hand motion in 6 (37.5%) patients and bad perception of light (PL) in 5 (31.3%) patients. Follow-up visual acuity was in form of good PL IN 4 (25%) patients and 1m/60 in 3 (18.8%) patients. There was a significant improvement in the visual acuity during follow-up in comparison to baseline visual acuity (2.83 ± 0.70 vs. 1.93 ± 0.84; P< 0.001)

CXL appears to be an effective procedure in treating non-resolving microbial keratitis with superficial stromal involvement. The most promising results published so far are for keratitis especially when the germs do not involve the posterior stroma and in cases of impending perforation.