What We Can Do in Infectious Keratitis, Except for Conventional Antimicrobial-Based Therapies: Major Narrative Review

Area of Science:

• Ophthalmology
• Microbiology
• Pharmacology

Background:

• Infectious keratitis (IK) is a serious eye condition requiring prompt treatment.
• Conventional antimicrobial therapies face challenges due to rising antimicrobial resistance.
• There is an urgent need for novel and adjunctive treatments for IK.

Purpose of the Study:

• To provide a comprehensive overview of current non-antimicrobial therapies for infectious keratitis.
• To discuss both medical and surgical non-antimicrobial treatment options.
• To evaluate therapies that can be used adjunctively or independently of antimicrobial treatments.

Main Methods:

• A systematic literature search was conducted on PubMed.
• Articles focusing on conventional antimicrobial treatments were excluded.
• Only English-language studies, excluding case reports, were considered.

Main Results:

• A wide range of non-antimicrobial therapies were identified and discussed.
• These include medical (e.g., povidone-iodine, MMP inhibitors), laser/light-based (e.g., PDT, UV-C), and surgical options (e.g., amniotic membrane transplantation, keratoplasty).
• Miscellaneous therapies such as nanomedicine and cryotherapy were also reviewed.

Conclusions:

• While conventional antimicrobials are standard for IK, emerging resistance necessitates alternative strategies.
• Non-antimicrobial therapies offer promising adjunctive or standalone treatment options.
• Further research is crucial to develop and optimize these alternative therapeutic approaches for better IK management.