Corneal Collagen Cross-Linking with Photoactivated Chromophore for Infectious Keratitis after Penetrating Keratoplasty
Cornea, cilt.39, sa.3, ss.283-289, 2020 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 39 Sayı: 3
- Basım Tarihi: 2020
- Doi Numarası: 10.1097/ico.0000000000002210
- Dergi Adı: Cornea
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database
- Sayfa Sayıları: ss.283-289
- Anahtar Kelimeler: PACK-CXL, chromophore, infectious keratitis, penetrating keratoplasty, graft failure, graft infection
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Purpose:To evaluate the efficacy and safety of corneal collagen cross-linking with photoactivated chromophore (PACK-CXL) plus medical treatment in comparison with the non-CXL group in the management of graft infections after penetrating keratoplasty.Methods:Forty eyes of 40 patients, 18 eyes in the PACK-CXL group and 22 eyes in the non-CXL group, with graft infections were retrospectively reviewed. Patients with microbial keratitis who were resistant to medical treatment for at least 1 week were treated with PACK-CXL in conjunction with medical treatment. The non-CXL group received only medical treatment.Results:The median (interquartile range) size of the infiltrate was 11 (3-12.7) versus 7.5 (3.5-12.7) mm2(P = 0.37), the epithelization time was 3 (2.7-5) versus 6 (3-11.2) days (P = 0.06), the complete healing time was 23.5 (17.7-33.5) versus 34 (27.7-41.2) days (P = 0.02), and the best-corrected distance visual acuity was 2.5 (0.5-3) versus 2.0 (0.9-3) logarithm of the minimum angle of resolution (P = 0.79) at presentation and 1 (0.3-3) versus 3 (1-3) logarithm of the minimum angle of resolution (P = 0.19) at the final visit for the PACK-CXL and non-CXL groups, respectively. Resolution of infiltrates was observed in 83.3% and 68.2% of cases in the PACK-CXL and non-CXL groups, respectively (P = 0.28). Graft failure was observed in 5 (27.8%) and 12 (54.5%) patients in the PACK-CXL and non-CXL groups, respectively (P = 0.08).Conclusions:PACK-CXL appears to be a promising adjuvant procedure in the management of resistant graft infections by reducing both the duration required for complete healing and rates of graft failure.