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Pilot study highlights potential of corneal cross-linking for treating infectious keratitis
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BOSTON — Corneal cross-linking may affect rapid resolution of corneal ulcers in patients with infectious keratitis, according to a speaker.
 Ramon Naranjo-Tackman |
Resolution of the ulcer, defined as reduction of at least 25% of the ulcer diameter and thickness, occurred in three of four eyes of patients treated with antibiotics and corneal cross-linking at a mean 1.75 weeks after treatment, Ramon Naranjo-Tackman, MD, said at the World Cornea Congress preceding the American Society of Cataract and Refractive Surgery meeting. In five patients treated with antibiotics alone, four patients had resolution of their corneal ulcer, but after a mean 3.33 weeks.
"Despite questions about the long-term effects of corneal cross-linking, and I myself have doubts about the long-term health of the limbal cells, we believe this can be effective in infectious keratitis," Dr. Naranjo-Tackman said.
Dr. Naranjo-Tackman said he used a modified cross-linking procedure for the treatment. After scraping of the epithelium surrounding the infection, riboflavin was applied, but ultraviolet radiation exposure was limited to 10 minutes, as opposed to 30 minutes as is usually done.
Application of UVA light and riboflavin was shown in vivo to have effects that carry potential benefit in treatment of infectious keratitis. It was shown to kill microorganisms, inhibit white blood cells and cross-link corneal collagen. These effects could reduce or eliminate the need for and toxicity of topical antibiotics, reduce scarring and amount of corneal stromal thinning, respectively. Further studies are needed to investigate the effects of UVA light and riboflavin in infectious keratitis.
– Erik Letko, MD
Indianapolis
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