Corneal Collagen Cross Linking With Photo-Activated Chromophore for keratitis (PACK-CXL) As AdjunctiveTherapy for Infectious Keratitis

Purpose. To report the profile of microbial keratitis occurring after corneal collagen cross-linking (CXL) in keratoconus patients.Methods. A retrospective analysis of 2350 patients (1715 conventional CXL, 310 transepithelial CXL, and 325 accelerated CXL) over 7 years (from January 2007 to January 2014) of progressive keratoconus, who underwent CXL at a tertiary eye care centre, was performed. Clinical findings, treatment, and course of disease of four eyes that developed postprocedural moxifloxacin resistantStaphylococcus aureus(MXRSA) infectious keratitis are highlighted.Results. Four eyes that underwent CXL (0.0017%) had corneal infiltrates. All eyes that developed keratitis had conventional CXL. Corneal infiltrates were noted on the third postoperative day. Gram’s stain as well as culture reported MXRSA as the causative agent in all cases. Polymerase chain reaction (PCR) in each case was positive for eubacterial genome. All patients were treated with fortified antibiotic eye drops, following which keratitis resolved over a 6-week period with scarring. All these patients were on long-term preoperative oral/topical steroids for chronic disorders (chronic vernal keratoconjunctivitis, bronchial asthma, and chronic eczema).Conclusion. The incidence of infectious keratitis after CXL is a rare complication (0.0017%). MXRSA is a potential organism for causing post-CXL keratitis and should be identified early and treated aggressively with fortified antibiotics.

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Corneal collagen cross-linking for infectious keratitis: an update of clinical studies

Acta Ophthalmologica ◽

10.1111/aos.12754 ◽

2015 ◽

Vol 93 (8) ◽

pp. 689-696 ◽

Cited By ~ 15

Author(s):

Tommy C. Y. Chan ◽

Tiffany W. S. Lau ◽

Jacky W. Y. Lee ◽

Ian Y. H. Wong ◽

Vishal Jhanji ◽

...

Keyword(s):

Clinical Studies ◽

Cross Linking ◽

Infectious Keratitis ◽

Collagen Cross Linking ◽

Corneal Collagen

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Effectiveness of adjuvant photoactivated chromophore corneal collagen cross-linking versus standard antimicrobial treatment for infectious keratitis

The JBI Database of Systematic Reviews and Implementation Reports ◽

10.11124/jbisrir-d-19-00148 ◽

2020 ◽

Vol 18 (1) ◽

pp. 194-199 ◽

Cited By ~ 1

Author(s):

Darren Shu Jeng Ting ◽

Christin Henein ◽

Dalia G. Said ◽

Harminder S. Dua

Keyword(s):

Antimicrobial Treatment ◽

Cross Linking ◽

Infectious Keratitis ◽

Collagen Cross Linking ◽

Corneal Collagen

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Accelerated corneal collagen cross-linking in clinical management of infectious keratitis

Journal of International Medical Research ◽

10.1177/0300060520926411 ◽

2020 ◽

Vol 48 (6) ◽

pp. 030006052092641

Author(s):

Miao Li ◽

Tao Yu ◽

Xin Gao ◽

Xin-Yi Wu

Keyword(s):

Visual Acuity ◽

Clinical Efficacy ◽

Corneal Thickness ◽

Anterior Segment ◽

Cross Linking ◽

Infectious Keratitis ◽

Biomechanical Parameters ◽

Collagen Cross Linking ◽

Corneal Collagen

Objective To evaluate the clinical efficacy of corneal collagen cross-linking (CXL) in the treatment of infectious corneal diseases. Methods This study retrospectively analyzed the clinical efficacy of CXL in 65 eyes with infectious keratitis in Jinan Second People’s Hospital from December 2016 to June 2018. During 6 months of follow-up after CXL treatment, the results of confocal microscopy and anterior segment optical coherence tomography, as well as visual acuity and corneal biomechanical parameters, were recorded in detail. Results In general, the overall cure rate was 93.85%; no corneal endothelial dysfunction was encountered in any patients. After 6 months of follow-up, the visual acuity of cured patients was significantly enhanced, while corneal thickness was significantly reduced. Hyphae growth of patients with fungal keratitis was completely inhibited at 1 month postoperatively. Furthermore, corneal biomechanical parameters (i.e., central corneal thickness, deformation amplitude, and pachymetry intraocular pressure) were significantly improved after surgery, compared with baseline measurements. Conclusion Accelerated CXL may be an effective adjuvant treatment for infectious keratitis.

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