CORNEAL COLLAGEN CROSSLINKING FOR THE TREATMENT OF MICROBIAL KERATITIS | ||||
| Egyptian Journal of Clinical Ophthalmology | ||||
| Article 2, Volume 5, Issue 2, December 2022, Page 67-77 PDF (568.36 K) | ||||
| Document Type: Original articles: include clinical trials, interventional research, Basic researches and clinically relevant laboratory investigations | ||||
| DOI: 10.21608/ejco.2022.280969 | ||||
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| Authors | ||||
| Hamza, A.; Abd El-Rahman, M.; Ali, T.; El-Sebaity, D. | ||||
| Ophthalmology dept., Faculty of Medicine, Assiut Univ., Egypt | ||||
| Abstract | ||||
| Introduction: Collagen cross-linking (CXL) is a new horizon in the treatment of corneal diseases. The corneal stroma is the thickest part of the cornea and is mainly composed of collagen fibrils, charged with stromal maintenance and wound healing. CXL by using UV rays and riboflavin could act as a photo mediator to inactivate pathogens in plasma, platelets, and red blood cells. Riboflavin also induces a change in properties of the collagen and has a stiffening effect on the corneal stroma, which stabilizes it and increases its resistance to enzymatic bacteria degradation avoiding the progression of corneal melting this study aimed to assess the efficacy and safety of corneal collagen cross-linking (CXL) in the management of infectious keratitis. Patients and methods: This study is prospective Interventional Non-comparative case series and included 16 eyes of 16 patients with clinical and lab (direct smear, culture, and sensitivity) evidence of microbial keratitis who attended the outpatient Cornea Unit, Ophthalmology department, Faculty of Medicine in Assiut University Hospital, Assiut. Data collected were detailed history and complete eye examination, including uncorrected visual acuity (UCVA), slit-lamp biomicroscopy, fundus examination, and intraocular pressure measurement for all patients. Results: 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). Conclusion: 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. | ||||
| Keywords | ||||
| Keratoconus; Anterior corneal astigmatism; Posterior corneal astigmatism | ||||
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