Collagen crosslinking in the management of microbial keratitis

OBJECTIVE The evaluation of the efficiency of corneal cross linking in the management of corneal ulcers. METHOD A prospective study that included 10 patients, 10 eyes, with chronic corneal ulcer, bacterial and/ or fungal. The patients were divided into two groups. Group A included 5 patients with unperforated corneal ulcer and group B included 5 patients with perforated corneal ulcer. These patients were treated with general and local antibiotic and antifungal drugs, but the response was poor after two weeks. The crosslinking procedure was performed and the local treatment was continued for two weeks. An additional partial or total conjunctival coverage was done on group B. Patients were evaluated after 3 days, one week, two weeks, one month, 3 months, 6 months and one year after the procedure. Slit lamp and tomographic aspects of the cornea were assessed as well as the visual acuity. RESULTS All ten patients experienced a decrease in pain from the first postoperative day. The ulcer healed by more than 50% in the first week in 3 patients from group A and closed completely after one month for 4 patients in group A, respectively 4 patients in group B. Hypopyon did not reappear after the crosslinking procedure in group A. However, it did persist in one patient from group B. Postoperative results were the same at 3, 6 and 12 months after the procedure. An opacification of the lens was observed in 3 patients after crosslinking. There were not any intra operative and postoperative complications. CONCLUSION Corneal crosslinking is efficient in the management of patients with chronic corneal ulcer.