Corneal stromal antibiotic implants: a novel therapy for posterior corneal infection

Session Details

Session Title: Presented Poster Session: Infections & Syndromes

Venue: Poster Village: Pod 3

First Author: : L.Daniel Raj Ponniah INDIA

Co Author(s): :    M. Ali                       

Abstract Details

Purpose:

To demonstrate the efficacy of implantable intra corneal sustained release antimicrobials in posterior corneal infections & abscesses.

Setting:

A prospective interventional non-comparative clinical trial at Department of Cornea, Dr.Agarwals Eye Hospitals, Tirunelveli, South India

Methods:

Cases with posterior corneal infections documented clinically and by AS-OCT were subjected to intra stromal sustained release implantable antimicrobials. A deeper corneal plane was fashioned either manually or by Femtosecond lasers with 1-2 incisions, through which antimicrobial implants were positioned. Results analyzed using AS-OCT and slit lamp photography. Implants removed in 3-5 days and re-implanted if required. Implantable antimicrobials were used in the interface during therapeutic lamellar keratoplasties also.

Results:

Out of 10 cases enrolled, 7 were primary implantation in deep corneal infections, and 2 were therapeutic lamellar keratoplasties, one a segmental infection in a Post DALK case in which implantable sustained release antimicrobials were used in the interfaces. 4 cases were fungal, 5 were bacterial, and 1 was nocardial. Healing started in 1-3 days, and implants were removed after 3-5 days. In 2 cases re-implantation was done which subsequently healed. All cases required reduced/no topical antimicrobial therapy. No surface toxicities were noted.

Conclusions:

Intrastromal corneal sustained release antimicrobial implants have a promise in deep corneal infections in terms of effective drug penetration and reduced surface toxicities

Financial Disclosure:

None