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Excimer laser ablative treatment of microbial keratitis
J D Gottsch1, M L Gilbert, D F Goodman
1Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine, Baltimore, MD.
Ophthalmology
|February 1, 1991
Summary
The 193-nm excimer laser effectively eradicated early fungal and mycobacterial keratitis in an animal model. However, advanced infections and potential corneal perforation limit its use for severe cases.
Area of Science:
- Ophthalmology
- Microbiology
- Laser Surgery
Background:
- Infectious keratitis poses a significant threat to vision.
- Current treatments for microbial keratitis have limitations.
Purpose of the Study:
- To evaluate the efficacy of 193-nm excimer laser photoablation in treating experimental fungal and mycobacterial keratitis.
- To determine the safety and limitations of excimer laser treatment for infectious keratitis.
Main Methods:
- Experimental keratitis models were created using Fusarium (fungal) and Mycobacterium fortuitum (mycobacterial) in animals.
- Infections were allowed to progress for 24 or 72 hours.
- Corneal ablation was performed using a 193-nm excimer laser, followed by microbiological and histopathological analysis.
Main Results:
- The excimer laser successfully eradicated infections in the 24-hour group (all cultures negative).
- Infections allowed to progress to 72 hours showed positive cultures post-treatment.
- Corneal perforation occurred in 3 of 8 eyes with M. fortuitum keratitis, despite shallow laser settings.
Conclusions:
- 193-nm excimer laser photoablation is effective for early, localized microbial keratitis.
- Advanced infections with deep stromal involvement are not suitable for this treatment.
- Caution is advised due to the risk of corneal perforation, limiting use to superficial lesions.