Cross-linking may provide alternative treatment for early infectious keratitis
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LAS VEGAS — Cross-linking may have a role as an alternative to antimicrobial therapy for early infectious keratitis, according to research presented at the American Society of Cataract and Refractive Surgery meeting.
Emilio A. Torres-Netto, MD, PhD, and colleagues analyzed the time to corneal epithelialization using photoactivated chromophore for infectious keratitis cross-linking (PACK-CXL) as first-line treatment in early corneal ulcers compared with antimicrobials, the current standard of care.
The study comprised 23 patients in the medication group and 19 in the PACK-CXL group. Patients in the PACK-CXL group underwent epithelial removal around the borders followed by application of riboflavin and irradiation with ultraviolet A and no other antimicrobial treatment.
Three patients in the medication group required corneal transplantation due to descemetocele and corneal perforation, while two patients in the PACK-CXL group required additional antimicrobial therapy.
Both groups had similar baseline average infiltrate or ulcer size and similar corrected distance visual acuity (CDVA). After treatment, there was no difference between the PACK-CXL and antimicrobial groups in epithelialization time or CDVA.
Torres-Netto said the research shows that cross-linking might be an alternative for first-line treatment of early to moderate infectious keratitis.
“With a tendency of slightly shorter healing time, 89% of eyes treated with PACK-CXL healed without the use of antimicrobial therapy,” he said. “The fluences that we used here — 5.4 J or 7.2 J — could be increased, potentially further improving clinical outcomes.”
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Torres-Netto EA, et al. Corneal cross-linking for treating infectious keratitis: Final results of the prospective randomized controlled multicenter trial. Presented at: American Society of Cataract and Refractive Surgery meeting; July 23-27, 2021; Las Vegas.
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