Alio Jorge L, Abbouda Alessandro, Valle David Diaz, Del Castillo Jose M Benitez, Fernandez Jose A Gegundez
Vissum Corporación Oftalmológica, Alicante 03016, Spain.
J Ophthalmic Inflamm Infect. 2013 May 29;3(1):47. doi: 10.1186/1869-5760-3-47.
Collagen cross linking (CXL) of the cornea has been developed recently as a new treatment for multidrug-resistant infectious keratitis. The aim of this study is to summarize the previously published data and evaluate the effectiveness of this treatment.
The search identified 12 articles. The number of eyes was 104. The infectious keratitis was associated with bacteria in 58 eyes (57f%): Gram-positive bacteria in 44 (43%; 4 of which were infected with Mycobacterium (3.6%)) and Gram-negative bacteria in 14 eyes (13%), fungus in 13 eyes (12%), and Acanthamoeba in 7 eyes (7%). In 26 eyes (25%), the microbiological culture was negative or not performed. The mean time of re-epithelization after CXL was 20.7±28.1 days (minimum of 3, maximum of 145). Sixteen eyes underwent deep or lamellar keratoplasty. The pooled analysis suggested that CXL has a favorable effect on the block of corneal melting in 85% (95%; CI 0.77, 0.91) of eyes.
Although randomized controlled trials are needed, the available evidence supports the use of CXL in the treatment of infectious keratitis.
角膜胶原交联（CXL）最近已发展成为一种治疗多重耐药性感染性角膜炎的新方法。本研究的目的是总结先前发表的数据并评估这种治疗方法的有效性。
检索到12篇文章。涉及104只眼睛。58只眼睛（57%）的感染性角膜炎与细菌有关：44只眼睛（43%）感染革兰氏阳性菌（其中4只感染分枝杆菌（3.6%）），14只眼睛（13%）感染革兰氏阴性菌，13只眼睛（12%）感染真菌，7只眼睛（7%）感染棘阿米巴。26只眼睛（25%）的微生物培养结果为阴性或未进行培养。CXL术后角膜重新上皮化的平均时间为20.7±28.1天（最短3天，最长145天）。16只眼睛接受了深层或板层角膜移植术。汇总分析表明，CXL对85%（95%置信区间0.77, 0.91）的眼睛阻止角膜融解有良好效果。
虽然需要随机对照试验，但现有证据支持使用CXL治疗感染性角膜炎。
