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Photo-activated riboflavin offers secondary treatment for infectious keratitis
Photo-activated riboflavin may be a safe adjunct treatment for infectious keratitis, particularly in cases of bacterial infection, according to a study.
The prospective, dual-center, interventional case series included 40 eyes of 40 patients aged 14 to 86 years.
Infectious organisms were identified in 33 eyes: bacterial species in 24 eyes, fungal infiltrates in seven eyes and protozoan species in two eyes. Six eyes showed no evidence of infectious organisms. Herpes simplex infection was identified in one eye after treatment. Seven eyes had undergone previous penetrating keratoplasty.
Eyes underwent instillation of riboflavin 0.1% solution at 2-minute intervals for 30 minutes and were exposed to 365-nm ultraviolet A light for 15 to 45 minutes. Topical riboflavin 0.1% was instilled at 5-minute intervals during ultraviolet A treatment. Standard antibiotic treatment was also continued.
Study results showed that keratitis did not resolve successfully in two bacterial cases and three fungal cases; all five eyes underwent penetrating keratoplasty.
Infection resolved in one eye with previous PK, but a re-graft was needed due to perforation of the PK incision.
Bacterial infections responded to riboflavin and ultraviolet A treatment better than fungal infections, the authors said.