Dr Mohammed Mohammed Mahdy Tawfeek Financial Disclosure 2021

Dr Mohammed Mohammed Mahdy Tawfeek Financial Disclosure 2021.

Photo-Activated Chromophore For Keratitis (PACK-CXL) Window Absorption (WA) Alone versus Combined PACK-CXL Window Absorption And Standard Anti-Microbial Therapy (SAT) For treatment of Infectious Keratitis: A Prospective Study..

Introduction. Infectious keratitis is a severe ocular infection and one of the leading causes of monocular blindness worldwide. Microbial keratitis requires aggressive management to halt the disease process (Shah et al, 2011). Most community-acquired cases of microbial keratitis resolve with empiric treatment using broad-spectrum topical antimicrobials. However, the emergence and spread of antimicrobial-resistant organisms remain a serious clinical concern (Bennett et al, 1998)..

Panda et al., (2012) summarized two major mechanisms of action of cross linking in the healing of corneal ulcers such as: Inactivation of pathogens by direct damage to pathogen DNA and prevention of its replication. Increased resistance to enzymatic degradation initiated by the increase in covalent bonds in the corneal stroma , together with anti-melting effect and enhancement of corneal healing..

A novel technique, named corneal cross-linking window absorption (CXL-WA), for the treatment of keratitis with CXL carried out without epithelial removal was introduced by (Rosetta et al .,2013) , in which, the center of ulcer was gently swiped to eliminate all cellular debris without total de- epithelization of the cornea creating window for riboflavin absorption and irradiation. A hypo- osmolar 0.1% riboflavin solution (RICROLIN TE Sooft , Italy) was instilled for 30 minutes before irradiation, to obtain stromal swelling..

Objectives The aim of this work is to compare the outcome of p PACK-CXL WA alone with combined PACK-CXL WA and SAT for treatment of infectious keratitis ..

Identification of organisms was done by lab study before treatment. Corneal healing was evaluated by corneal examination and anterior segment OCT (AS-OCT). Results.

Perforation and impending perforation were found in 3 patients of group (A) and only one patient of group (B ). Conclusions PACK-CXL is a promising, non-invasive treatment option for superficial infectious keratitis, especially when performed with window absorption (WA) technique, either alone or combined with SAT. However, Combined PACK-CXL WA with SAT is more effective for treatment of infectious keratitis than PACK-CXL WA alone with shorter resolution period..