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Corneal cross-linking may be an alternative way to treat infectious keratitis
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ORLANDO, Fla. — Corneal cross-linking shows promise as an adjunctive treatment of infectious keratitis and other ocular surface diseases, a speaker said here.
Jes Mortensen, MD, described the novel treatment approach during Refractive Subspecialty Day preceding the American Academy of Ophthalmology meeting.
"We found that [corneal cross-linking] for bacterial keratitis works by multiple mechanisms, induces oxidative stress, motivates the immune response and increases resistance to collagen-degrading enzymes," Dr. Mortensen said.
A case of suspected Acanthamoeba keratitis treated with corneal cross-linking in Scandinavia showed promising results in 2007, Dr. Mortensen said. Subsequently, cross-linking has been applied to cases of microbial keratitis and sterile ulcers, he said.
Photoactivation of riboflavin by ultraviolet light results in oxidative stress and produces antimicrobial effects, Dr. Mortensen said. It is also believed that photosensitized riboflavin interferes with the RNA and DNA of micro-organisms, creating breaks in the strands of genetic material.
Cross-linking also boosts resistance to enzymes that degrade collagen and ultimately cause corneal melting, Dr. Mortensen said.
A small pilot study included 16 patients who underwent cross-linking to treat bacterial keratitis in 2009. Results showed that all eyes responded to treatment.
The patients underwent cross-linking for infectious keratitis in outpatient centers and were not prescribed antibiotics, Dr. Mortensen said.
Experimental and clinical research is ongoing.
- Disclosure: Dr. Mortensen has no relevant financial disclosures.