Steroids And Cross-Linking For Ulcer Treatment Trial Ii (Scut Ii): Secondary 12 Month Clinical Outcomes Of A Randomized Controlled Trial
Published 2026 - 44th Congress of the ESCRS
Reference: PP20.16 | Type: Free paper | DOI: 10.82333/snda-kx48
Authors: Dr Filippos Vingopoulos* 1 , Dr Venkatesh Prajna 2 , Dr Lalitha Prajna 2 , Dr Sumithra Chnadru 2 , Dr Naveen Radhakrishnan 2 , Dr Josephine Christy 2 , Dr Anitha Karthikeyan 2 , Dr Revathi Rajaraman 2 , Dr Rahul Ramesh 2 , Dr Guillermo Amescua 3 , Kunal Mandlik 2 , Sarah Abdelrahman 4 , Nicole Varnado 1 , Maalika kunchlagantla 1 , Benjamin Arnold 4 , Thomas Lietman 4 , Jennifer Rose 1
1Ophthalmology,Stanford,Palo Alto,United States, 2Ophthalmology,Aravind,Madurai,India, 3Ophthalmology,Bascom Palmer Eye Institute,Miami,United States, 4Ophthalmology,UCSF,San Francisco,United States
Purpose
To determine whether adjunctive topical corticosteroids and/or CXL improve long-term clinical outcomes in bacterial keratitis.
Setting
Patients in cornea clinics at the Aravind Eye Hospitals in India or to the Bascom Palmer Eye Institute at the University of Miami
Methods
NIH-funded randomized, double-masked, sham and placebo-controlled trial. Eligible participants were randomized 1:1:1 to of of three treatment arms: (1) topical 0.5% moxifloxacin plus topical placebo plus sham CXL, (2) topical 0.5% moxifloxacin plus difluprednate 0.05% plus sham CXL, (3) topical 0.5% moxifloxacin plus difluprednate 0.05% plus CXL. All participants had smear and/or culture positive bacterial corneal ulcers with Snellen visual acuity of 20/40 or worse. Main outcomes included LogMAR best spectacle-corrected visual acuity (BSCVA) and infiltrate and/or scar size as 12 month secondary outcomes of the Steroids and Cross-linking for Ulcer Treatment Trial II (SCUT II).
Results
Of 280 participants that were enrolled in SCUT II, 200 (71%) had 12 month BSCVA outcomes and 192 (69%) had 12 month infiltrate and/or scar size outcomes. Controlling for baseline BSCVA, there was no difference in 12 month BSCVA with adjunctive topical steroid versus placebo (-0.07; CI -0.22 to 0.07; P=0.33) or with adjunctive crosslinking and topical steroid versus adjunctive topical steroid alone (0.05; CI -0.10 to 0.19; P=0.51). Correcting for baseline infiltrate/scar size, there was no difference in 12 month infiltrate/scar size with adjunctive topical steroid versus placebo (-0.15; CI -0.54 to 0.24; P=0.451) or with adjunctive crosslinking and topical steroid versus adjunctive topical steroid alone (0.47; CI -0.001 to 0.95; P=0.055).
Conclusions
We were unable to find additional clinical benefit or harm of adjunctive topical steroids for bacterial keratitis in terms of visual acuity or scar size at 12 months.