Repeated Sessions Of Pack-Cxl Wa For The Treatment Of Resistant Bacterial Keratitis: A Retrospective Study
Published 2025 - 43rd Congress of the ESCRS
Reference: PO501 | Type: Free paper | DOI: 10.82333/ws1s-jg58
Authors: Ahmed Mostafa 1 , Ahmed Mostafa* 2
1OPHTHALMOLOGY,NMC ROYAL HOSPITAL Sharjah,sharjah ,United Arab Emirates;NMC ROYAL SHARJAH,sharjah,United Arab Emirates, 2OPHTHALMOLOGY ,NMC ROYAL HOSPITAL Sharjah,sharjah ,United Arab Emirates
Purpose
The aim of this work is to evaluate the safety and efficacy of repeated sessions of photo-activated
chromophore for keratitis-cross linking (PACK-CXL) window absorption (WA) for the treatment of resistant bacterial
keratitis (BK).
Setting
Patients were collected from El-Tayseer Eye Hospital in
Zagazig, Egypt, in the period from May 2022 to November
2022 where all the surgical procedures were carried
out.
Methods
This is a retrospective clinical cohort study. Thirty eyes with clinically suspected and lab-confirmed
bacterial keratitis, resistant to appropriate antibiotic therapy for
2 weeks with failure of epithelialization for 4 weeks after the standard anti-microbial therapy (SAT) together with one
setting of PACK-CXL WA were included. If after the first session of PACK-CXL, there is a start of improvement in the
form of reduction of the size of corneal ulcer and stromal infiltrates together with the start of epithelialization on
clinical examination and AS-OCT, another session of PACK-CXL WA was performed after one week, and so on, till the
complete healing and resolution of bacterial keratitis and confirmation by negative bacterial culture.
Results
Thirty eyes of 30 patients were recruited in this study. They were 16 males and 14 females, their mean
age was 44.3 ± 5.38 years. The mean ulcer size was 3.96 ± 1.87 (mm3), while the mean size of stromal infiltrates was
4.52 ± 2.24 (mm3). PACK-CXL WA treatment was performed an average of 2.87 times for the 30 eyes. Complete healing
and resolution (Successful treatment) was observed in 27 eyes (90%) of cases and failure of epithelialization was
observed only in 3 eyes (10%). Complete corneal healing was reported in the second month postoperatively in 90%
of eyes.
Conclusions
PACK-CXL WA may be a promising, non-invasive treatment option for resistant
bacterial keratitis. It may have a synergistic effect with standard antimicrobial treatment (SAT). Also, it can overcome
the antibiotics resistance that has become rapidly spreading worldwide. Repeated sessions of PACK-CXL WA may be
more effective for the treatment of resistant bacterial keratitis till complete epithelialization and resolution of BK than a single session with few complications. However, further prospective and comparative studies to support the results are needed.