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Published on: November 22, 2024
Photoactivated chromophore corneal cross-linking (PACK-CXL) for treatment of severe keratitis
Elfa Alidrus Idrus1,2, Elina Maria Utti2, Jaakko S Mattila2
1Ophthalmology unit, Merauke Government Public Hospital, Merauke, Papua, Indonesia.
Purpose:
To report our experience with photoactivated chromophore corneal cross-linking (PACK-CXL) for treating keratitis patients.
Methods:
This retrospective study consists of 27 eyes of 26 patients with infectious keratitis treated with PACK-CXL at the Helsinki University Hospital between 2009 and 2017. Patients were treated with antibiotics/antifungal medications and underwent PACK-CXL procedure due to lack of clinical response or severe corneal melts. For twenty patients, amniotic membrane transplant (AMT) was done during the same day. Follow-up after cross-linking ranged from 1 week to 12 months.
Results:
Sixteen infections were related to contact lens wear. Of the 19 eyes showing positive culture, the predominant micro-organism was Pseudomonas aeruginosa (9 cases). The average re-epithelization time was 13 days and in 15 cases (56%) the re-epithelization occurred within one week. In 26 eyes, visual acuity increased and seven patients (26%) had a final visual acuity more or equal to 0.5 (20/40) Snellen.
Conclusions:
PACK-CXL seems to be a safe and potential option for treating patient with infectious keratitis who do not respond to antibiotic therapy.
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