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Photo-activated chromophore for keratitis (PACK-CXL) as adjunctive therapy for infectious keratitis: a prostpective study

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First Author: M.Tawfeek EGYPT

Co Author(s):    K. Ammar   M. Hosny   H. Enany              

Abstract Details

Purpose:

The aim of this work is to evaluate efficacy and safety of corneal collagen cross linking as adjunctive therapy for treating infectious keratitis.

Setting:

Zagazig and Cairo University Hospitals.

Methods:

This is a randomized prospective controled clinical trial. Seventy eight (78) eyes with clinically suspected infectious keratitis were enrolled . The range of age of the enrolled patients was more than or equal to 18 years. They were randomly classified into two groups each of 39 eyes, Group A(control group): received topical appropriate conventional broad spectrum antimicrobial therapy alone based on sensitivity reports and Group B: As group(A) together with corneal collagen cross linking for infectious keratitis(PACK-CXL). Identification of organisms was done by lab study before treatment. Corneal healing was evaluated by corneal examination and anterior segment OCT ( AS-OCT).

Results:

Complete healing and resolution (Successful treatment) was observed in 76.9 % of eyes and 97.4 % of patients in groups (A & B), respectively. They showed a statistically highly significant difference (P <0.001). Mean resolution period was 10.87±3.28 and 7.02±2 weeks in group (A & B), respectively, with statistically significant difference (P = 0.002) between both groups, being shorter in group (B).Only 2.6% of our cases had resistance to treatment in CXL compared to group A, who had 23.1% of resistance. There was no statistically significant difference between both groups as regards complications of treatment.

Conclusions:

PACK-CXL is a promising , non-invasive and available treatment option. It has a synergistic effect with antimicrobial treatment that gives a good outcome results in treatment of infectious keratitis. Also, it avoids the antibiotics resistance that has become rapidly spreading worldwide.

Financial Disclosure:

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