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Modified cross-linking (M-CXL) in the treatment of purulent keratitis and corneal ulcers

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First Author: E.Kasparova RUSSIA

Co Author(s):    E. Kasparova   B. Yang                 

Abstract Details

Purpose:

To evaluate the efficacy of modified cross-linking (M-CXL) in the treatment of purulent corneal ulcers, including those of mixed etiology.

Setting:

FGBNU State Research Institute on Eye Diseases, Moscow, Russian Federation

Methods:

The M-CXL method consists of simultaneous cross-linking and frequent instillations (FI) of anti-infective solutions. We observed 36 patients (37 eyes) with purulent corneal ulcers (PCU) of various etiologies. The test group included 24 patients (24 eyes) who received 1-2 sessions of M-CXL with active conservative therapy. In the control group (12 patients, 13 eyes), only active conservative therapy was performed.

Results:

Complete reduction of the purulent process was achieved in 18 (75%) eyes in 29.6+9.38 days in the test and in 8 eyes (61.5%) in 50.4+15.9 days in the control group. The efficiency of M-CXL ranged from 100% to 66.6% depending on depth and width (square area) of the infiltration in question. In cases where infiltration affected the entire stromal thickness, M-CXL efficacy sharply decreased to 66.6%, even when the square area was small (< 6 mm). In cases where infiltration extended to the Descemet's membrane with an overall area (>7 mm), the clinical effect of M-CXL was absent or insufficient.

Conclusions:

In 75% cases, M-CXL showed complete reduction of infectious keratitis. The recovery time in the test group was 1.6-times shorter than that in the control group (P <0.05). We did not achieve resorption of the purulent focus in cases with wide area and full thickness (up to the Descemet's membrane) infiltration. However, it`s spread and purulent fusion were sufficiently suspended, thereby allowing therapeutic penetrating keratoplasty to be performed with a smaller graft diameter and calmer eye.

Financial Disclosure:

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