Hsia Yen C, Moe Caitlin A, Lietman Thomas M, Keenan Jeremy D, Rose-Nussbaumer Jennifer
Department of Ophthalmology, University of California, San Francisco, California, USA.
Francis I Proctor Foundation, University of California, San Francisco, California, USA.
BMJ Open Ophthalmol. 2018 Mar 16;3(1):e000112. doi: 10.1136/bmjophth-2017-000112. eCollection 2018.
To assess the current opinion and practice patterns from cornea experts regarding the benefit of corneal cross-linking (CXL) for infectious keratitis (IK).
An international survey was distributed to corneal specialists via an internet survey. The survey data collected were analysed with descriptive statistics.
A survey was sent to 190 recipients, and 29 (15%) respondents completed the survey with an average of 7 years' experience using CXL. A majority of respondents (66%) used CXL to treat IK due to bacterial, fungal, protozoan or unknown aetiology. Main indications to use CXL as adjuvant therapy were worsening infiltrate diameter or depth despite therapy (74%), followed by antibiotic resistance (68%), corneal thinning (53%), poor compliance with medication (26%) and other reasons (21%). Most respondents felt CXL would be at least moderately helpful as an adjuvant therapy for bacterial (96%) or fungal (75%) keratitis; about half (46%) thought it would be helpful for acanthamoeba keratitis. As sole therapy, fewer respondents believed CXL would be at least moderately helpful to treat bacterial (75%), fungal (58%) and acanthamoeba (43%) keratitis.
The survey offered insights into current expert practices and opinions of using CXL as therapy for IK. The results of this survey serve to guide in the design of future clinical studies.
评估角膜专家对于角膜交联术（CXL）治疗感染性角膜炎（IK）的益处的当前观点和实践模式。
通过网络调查向角膜专科医生发放一份国际调查问卷。对收集到的调查数据进行描述性统计分析。
向190名受访者发送了调查问卷，29名（15%）受访者完成了调查，他们使用CXL的平均经验为7年。大多数受访者（66%）使用CXL治疗由细菌、真菌、原生动物或病因不明引起的IK。将CXL用作辅助治疗的主要指征是尽管进行了治疗但浸润直径或深度仍在恶化（74%），其次是抗生素耐药（68%）、角膜变薄（53%）、药物治疗依从性差（26%）和其他原因（21%）。大多数受访者认为CXL作为细菌（96%）或真菌（75%）性角膜炎的辅助治疗至少会有一定帮助；约一半（46%）的人认为对棘阿米巴角膜炎会有帮助。作为单一治疗方法，较少受访者认为CXL对治疗细菌（75%）、真菌（58%）和棘阿米巴（43%）性角膜炎至少会有一定帮助。
该调查深入了解了当前专家使用CXL治疗IK的实践和观点。本次调查结果有助于指导未来临床研究的设计。
