“Corneal CXL for the Treatment of Non-Responding Infectious Keratitis ”Cristian A. Cartes, MD ; Miguel Srur, MD; Leonidas Traipe, MD

Fundación Oftalmológica los Andes, Santiago, Chile.

The authors have no financial

interest in the subject matter of

this research

Purpose

To report the use of corneal collagen crosslinking in the treatment of infective keratitis not responding to antimicrobial therapy.

Methods

Retrospective, case series of  patients with infectious keratitis unresponsive to antimicrobial therapy. Patients were treated by instilling riboflavin 0.1% solution for 10 minutes to saturate the cornea, followed by exposure to UVA light for 20 minutes. The primary outcome was the time to resolution of the epithelial defect.

Results

• Eleven patients (13 eyes) were

included.

• After riboflavin and UV collagen

crosslinking therapy, there was a

rapid decrease of pain.

Results

Patient EyeGende

rVA pre

VA post

Epithelization

Melting

Emergency PKP

1 R f light light 172 no no

2 L f 0.05 0.05 Neurotrophic ulcer no no3 L f light light 142 no no4 R f cf 0.03 21 no no5 R f n.a no yes yes

L f n.a no yes yes6 L m cf cf 112 no no7 R m hm hm 22 no no8 R m 0.05 0.1 3 no no

9 L f hm cf Neurotrophic ulcer no no10 R f hm hm 45 no no

L f cf cf 82 no no11 L m n.a no yes yes

Hm: hand motion, cf: counting fingers, n.a.: not availabe

Results

38%

23%

8%

31%

Etiology

Protozoal Bacterial Fungal Unknown

Conclusion

• This serie suggests the positive effects of

riboflavin and UV collagen crosslinking on

infectious keratitis unresponsive to antimicrobial

therapy.

• We think this treatment should  be considered in

refractive keratitis.

• Randomized studies are needed to further

evaluate efficacy.

“Corneal CXL for the Treatment of Non-Responding Infectious Keratitis ”Cristian A. Cartes, MD (Presenting Author); Miguel Srur, MD; Leonidas

Traipe, MD

Fundación Oftalmológica los Andes, Santiago, Chile.

Mail to: ccartesindo@gmail.com