Kono Yusuke, Kamiya Kazutaka, Kobashi Hidenaga, Igarashi Akihito, Shimizu Kimiya
Nippon Ganka Gakkai Zasshi. 2016 Dec;120(12):831-6.
Purpose: Corneal collagen crosslinking (CXL) is effective not only in halting the progression of keratoconus but also in management of infectious keratitis. However, as far as we can ascertain, there are no reports of CXL for the treatment of severe infectious keratitis in Japan. Thus, we report 2 cases in which CXL was effective for infectious corneal ulcer. Cases: A 82-year old man and 76-year-old woman. Both of which were treated with local antibiotic therapy; however, the therapy was not empirically effective. Thus, we performed CXL following the standard Dresden protocol after obtaining informed consent from each case. Two weeks after CXL, slit-lamp examinations revealed improvements of corneal transparency and keratitis in each case. No serious complications such as corneal perforations and infectious recurrences occurred after the treatments. Conclusion: Two cases of infectious keratitis improved in corneal opacity and had showed inhibitory effect on infected cornea. CXL seems to be an effective therapeutic alternative in resistant cases of infectious keratitis, although the exact etiology of this effective treatment remains unclear.
角膜胶原交联（CXL）不仅在阻止圆锥角膜进展方面有效，而且在感染性角膜炎的治疗中也有效。然而，据我们所知，在日本尚无CXL治疗严重感染性角膜炎的报道。因此，我们报告2例CXL治疗感染性角膜溃疡有效的病例。病例：一名82岁男性和一名76岁女性。两人均接受了局部抗生素治疗；然而，该治疗经验性无效。因此，在获得每个病例的知情同意后，我们按照标准的德累斯顿方案进行了CXL。CXL两周后，裂隙灯检查显示每个病例的角膜透明度和角膜炎均有改善。治疗后未发生角膜穿孔和感染复发等严重并发症。结论：2例感染性角膜炎的角膜混浊有所改善，且对感染角膜有抑制作用。尽管这种有效治疗的确切病因尚不清楚，但CXL似乎是感染性角膜炎耐药病例的一种有效治疗选择。
