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PACK-CXL Window Absorption Alone versus Combined PACK-CXL Window Absorption And Standard Anti-Microbial Therapy For treatment of Infectious Keratitis: A prospective Study.

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First Author: M.Mahdy Tawfeek EGYPT

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Abstract Details

Purpose:

Objective: The aim of this work is to compare the outcome of photoactivated chromophore for keratitis-cross linking (PACK-CXL) window absorption (WA) alone with combined PACK-CXL WA and standard anti-microbial therapy (SAT) for treatment of infectious keratitis.

Setting:

Sharkia Eye Center , Zagazig , Sharkia , Egpyt . Author Affiliation: Lecturer of ophthalmology , Faculty Of Medicine , Zagazig University

Methods:

This is a randomized prospective comparative clinical trial. Thirty eyes with clinically suspected infectious keratitis were randomly assigned into two equal groups of 15 eyes each: Group (A) was treated by PACK-CXL WA alone and group (B) was treated by PACK-CXL WA combined with SAT. Identification of organisms was done by lab study before treatment. Corneal healing was evaluated by corneal examination and anterior segment OCT (AS-OCT).Written informed consent was obtained from all participants and the study was approved by the research ethical committee of Faculty of Medicine, Zagazig University.

Results:

Complete healing was observed in 10 eyes (66.7%) of group (A) and 14 eyes (93.3%) of group (B) and failure was observed in 5 eyes (33.3%) of group (A) and one eye (6.67%) of group (B). They were statistically significant (P =0.042 and 0.003) in comparison between both groups regarding success and failure of treatment, respectively. Complete corneal healing was reported in the third month in 10 eyes (66.7%) of group (A) and 14 eyes (93.3%) of group (B). Complications were absent in 12 patients (80%) in group (A) and 14 patients (93.3%) of group (B).

Conclusions:

Conclusion: PACK-CXL is a promising, non-invasive treatment option for infectious keratitis, especially when performed with window absorption (WA) technique, either alone or combined with SAT. It has a synergistic effect with standard antimicrobial treatment that gives 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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