Original articleCollagen Cross-Linking with Photoactivated Riboflavin (PACK-CXL) for the Treatment of Advanced Infectious Keratitis with Corneal Melting
Section snippets
Methods
This prospective clinical trial was conducted between January 2010 and April 2013 at the Cornea Clinic of the Research Institute of Ophthalmology, Cairo, Egypt, in collaboration with the Department of Ophthalmology, Beni-Suef University Hospitals, Beni-Suef, Egypt; the Rowad Correction Centre, Cairo, Egypt; the Department of Ophthalmology, University of Nottingham, Nottingham, United Kingdom; and the Department of Ophthalmology, University of Geneva, Geneva, Switzerland. The Research Institute
Results
The PACK-CXL group included 21 patients (8 men and 13 women) with a mean age of 37.3 years. The control group included 19 patients (10 men and 9 women) with a mean age of 49.8 years. The baseline corrected distance visual acuity at presentation was 2.16±0.35 logarithm of the minimum angle of resolution (logMAR) units in the PACK-CXL group and 2.01±0.44 logMAR in the control group (P = 0.11). The isolated causative micro-organisms for each group are shown in Table 1 for the PACK-CXL group and in
Discussion
Infectious keratitis is a severe ocular infection and one of the leading causes of monocular blindness worldwide.18 The incidence of microbial keratitis ranges from 6.3 to 710 cases per 100 000 population per year and is even more common in contact lens wearers.19 Various micro-organisms, including bacteria, viruses, fungi, and parasites, may cause infectious keratitis. This infection and inflammatory reaction may lead to ulceration, corneal melting, and perforation if not treated adequately.
Acknowledgments
The authors thank Joerg Sommerhalder, PhD, for his support for the statistical analysis and Masood Samani, MD, for his insightful comments on the Jarisch-Herxheimer reaction.
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Financial Disclosure(s): The author(s) have made the following disclosure(s): Farhad Hafezi - Coinventor - PCT/CH 2012/000090 application (ultraviolet light source).
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Both Dr. Said and Dr. Elalfy contributed equally as first authors.