Posters

Collagen cross-linking in the treatment of resistant corneal ulcers between patients in the Nile Delta

Poster Details

First Author: H. Khairy EGYPT

Co Author(s):    S. Motawee   H. Elsobky                 

Abstract Details

Purpose:

The aim of this study was to evaluate the safety and efficacy of Corneal Cross-Linking (Pack-CXL) with UVA in the treatment of resistant corneal ulcers.

Setting:

This prospective clinical study was conducted between March 2014 and February 2015 at Ophthalmology Department, Menoufia University Hospital, Egypt.

Methods:

At presentation, all pre-existing treatment was interrupted for 24 hours and corneal scrapes for direct smears and cultures were obtained.All patients had aregime of fortified antibiotics drops, and antifungal tablets. Corneal collagen cross-linking was done to all patients using CBM Vega Cross Linking System, 365-nm ultraviolet A with an irradiance of 3 mW/cm2 for 30 minutes, and a total dose of 5.4 J/cm2. All patients were kept on treatment after the CXL for a varying time ranging from 1 week to approximately 3 months, until complete epithelialization occurred.

Results:

This study included 15 eyes.Staphylococcus aureus was the main isolated bacterial organism which was found in 7 cases [46.7 %], E-Coli and Streptococcus pneumoniae were present in one patient each. Aspargillus fumigates was found in 2 patients and candida albicans was found in one patient. Out of 15 eyes, nine eyes (60%) healed without complication or surgical intervention with a mean time needed for healing of 33.7 day. Complications were present in 40% as following: • Three cases developed hypopyon (20%) which needed prolonged treatment • One eye showed descemetocele formation (6.7%) and surgical intervention was needed in the form of amniotic membrane transplant • One eye had perforation (6.7%) needed corneal glue. • One eye showed no response (6.7%) and finally needed tarrsoraphy

Conclusions:

Combinationof CXL and medical treatment did not seem to offer additional significant benefits over the use of medical treatment alone. Considering the cost of CXL, it is practically difficult to use CXL as an adjuvant treatment unless its benefits are sharply defined.

Financial Disclosure:

NONE