EVALUATION OF CROSS-LINKING OF DONOR CORNEAS FOLLOWING THERAPEUTIC KERATOPLASTY IN CASES OF INFECTIOUS KERATITIS.

Currently, Collagen crosslinking (CXL) is used as a treatment modality in infectious keratitis. This study aims to explore its role in prevention of re-infection after therapeutic keratoplasty.

The purpose of this study is to evaluate cross-linking of donor corneas following therapeutic keratoplasty in cases of Infectious Keratitis.

Prospective interventional study

This was a prospective, interventional study conducted at Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, Delhi. The cases undergoing therapeutic keratoplasty(TPK) for perforated corneal ulcer, non-healing corneal ulcers and graft infections, who are willing to participate in the study and follow up were included. Therapeutic penetrating keratoplasty was performed in all the cases followed by accelerated corneal collagen cross-linking (TPK-CXL). Patients were followed up to 6 months post operatively.

TPK-CXL was performed in 47 corneal ulcer cases. The mean age of the cohort was 54.31(SD 14.58) years. Of them 77% were males. The median visual acuity before surgery was 2.39 log MAR. The mean area of the infiltrate was 43.48mm2. Among all the cases 44.6% were perforated. At 3 months follow up, 3 of the patients had graft infection, one underwent TPK and two underwent glue BCL. Peristent epithelial defect was noted in 2 cases and AMG was performed in both. At 6 months, none of them had any graft infections, one eye developed phthisis bulbi and there were no cases of graft rejection and corneal melt.

TPK-CXL is a safe procedure and does not confer additional risk as compared to TPK alone. A randomised study with larger sample size is required to confirm the efficacy of TPK CXL in reducing graft infections