Department of Ophthalmology, Istituto Clinico Humanitas, Milan, Italy.
Cornea. 2013 Apr;32(4):550-4. doi: 10.1097/ICO.0b013e318259c9bb.
To evaluate the safety and efficacy of treatment of severe infectious corneal ulcers with hypoosmolar riboflavin solution and UV-A collagen cross-linking (CXL) without deepithelizing the cornea.
Four eyes of 3 patients with severe keratitis and associated corneal melting, were treated with a new protocol of corneal CXL for infectious keratitis, named cross-linking window absorption (CXL-WA). CXL-WA was performed when the infection did not respond to systemic and topical antibiotic therapy. The protocol entails the use of hypoosmolar riboflavin before the irradiation with UV-A, and the penetration is obtained through the epithelial defect overlying the ulcer.
In all cases, CXL halted the progression of the ulcer. After a minimum follow-up of 3 months, none of the patients had recurrence of the infection.
CXL-WA is a promising technique of treatment of infectious corneal ulcers, delaying or preventing more invasive approaches.
评估无角膜去上皮处理的低渗核黄素溶液联合 UV-A 胶原交联（CXL）治疗严重感染性角膜溃疡的安全性和疗效。
对 3 例严重角膜炎合并角膜融解患者的 4 只眼，采用一种新的感染性角膜炎 CXL 方案（交联窗口吸收[CXL-WA]）进行治疗。当感染对全身和局部抗生素治疗无反应时，进行 CXL-WA。该方案在 UV-A 照射前使用低渗核黄素，并通过溃疡上方的上皮缺损进行渗透。
所有病例中，CXL 均阻止了溃疡的进展。随访至少 3 个月后，患者均未出现感染复发。
CXL-WA 是治疗感染性角膜溃疡的一种很有前途的技术，可以延迟或避免更具侵袭性的治疗方法。
