Riboflavin/UVA Photochemical Therapy for Severe Infectious Keratitis. Issue 1 (January 2014)

• Record Type: Journal Article
• Authors: Skaat, Alon; Zadok, David; Goldich, Yakov; Varssano, David; Berger, Yoav; Ezra-Nimni, Orit; Avni, Isaac; Barequet, Irina S.
• Is Part Of: European journal of ophthalmology. Volume 24:Issue 1(2014)
• Page Start: 21
• Page End: 28
• Publication Date: 2014-01
• Subjects: Collagen crosslinking -- Cornea -- Infiltrate -- Riboflavin -- Ultraviolet A light; Ophthalmology -- Periodicals; Eye -- Diseases -- Periodicals; 617.7005
• DOI: 10.5301/ejo.5000330
• Languages: English
• ISSNs: 1120-6721

Abstract

Purpose: To describe the antibacterial activity of treatment with riboflavin and ultraviolet A light (UVA) in cases of severe infectious keratitis. Methods: A retrospective analysis was performed of an interventional case series in which 6 eyes of 6 patients with severe infectious keratitis, all of whom were refractive to multidrug conventional therapy, were treated with riboflavin/UVA. The procedure was conducted according to the standardized protocol of corneal collagen crosslinking (CXL) for keratoconus. Best spectacle-corrected visual acuity and clinical outcomes were evaluated before and during the follow-up period. Results: Five of the 6 patients showed rapid reduction in symptoms and decreased infiltrate size after riboflavin/UVA photochemical therapy. Signs of infection and inflammation mostly resolved within 1 to 2 weeks after the treatment. Despite this therapy, one patient continued to deteriorate, and penetrating keratoplasty was performed. Conclusions: The adjunctive use of riboflavin/UVA photochemical therapy has a positive effect on refractory infectious keratitis. The treatment seems to be safe and effective and should be considered as part of the first-line therapy in severe cases of infectious keratitis.