Saini Sanchita, Singh Satyaprakash, Dwivedi Kshama, Singh Sanskriti, Kumar Santosh, Rana Jagriti
Department of Ophthalmology, King George Medical College, Lucknow, Uttar Pradesh, India.
Department of Ophthalmology, Regional Institute of Ophthalmology, Government M. D. Eye Hospital, Prayagraj (Allahabad), Uttar Pradesh, India.
Indian J Ophthalmol. 2022 May;70(5):1571-1577. doi: 10.4103/ijo.IJO_2693_21.
To assess Photo Activated Chromophore for Infective Keratitis-Cross Linking (PACK-CXL) and its efficacy as a treatment modality in managing microbial keratitis.
Single Centre prospective interventional study in infectious keratitis. A total of eleven patients were taken who had corneal thickness (CT) more than 400μm. PACK-CXL was performed according to Dresden's protocol. The response was assessed by slit lamp examination, BCVA and AS-OCT at the time of complete healing.
The mean visual acuity at presentation was 1.207logMAR (0.3-3) which improved to mean value of 0.53logMAR (0.3-1). Mean time taken for complete epithelization was 17.45 days (14- 30 days) and that for complete healing was 33.72 days (21- 60 days). Mean CT at the baseline was 650.5± 108μm which reduced on consecutive follow up visits. There was reduction in the symptoms in nine patients except in two. One case reported increase in symptoms with worsening increase in endoexudates and hypopyon, and the other developed drug toxicity due to topical medications.
Patients who underwent PACK-CXL showed good and early healing, good remodelling of cornea and improved visual acuity. The recalcitrant cases became responders to the same medications after PACK-CXL. Thus, PACK-CXL works well for both fungal and bacterial keratitis.
评估用于感染性角膜炎的光活化色团交联术（PACK-CXL）及其作为治疗微生物性角膜炎的一种治疗方式的疗效。
对感染性角膜炎进行单中心前瞻性干预研究。共纳入11例角膜厚度（CT）超过400μm的患者。PACK-CXL按照德累斯顿方案进行。在完全愈合时通过裂隙灯检查、最佳矫正视力（BCVA）和眼前节光学相干断层扫描（AS-OCT）评估反应情况。
就诊时的平均视力为1.207logMAR（0.3 - 3），改善至平均0.53logMAR（0.3 - 1）。完全上皮化的平均时间为17.45天（14 - 30天），完全愈合的平均时间为33.72天（21 - 60天）。基线时的平均角膜厚度为650.5±108μm，在连续随访中逐渐降低。除2例患者外，9例患者的症状有所减轻。1例患者报告症状加重，伴有眼内渗出物增加和前房积脓，另1例因局部用药出现药物毒性。
接受PACK-CXL治疗的患者显示出良好且早期的愈合、角膜的良好重塑以及视力改善。难治性病例在PACK-CXL后对相同药物有反应。因此，PACK-CXL对真菌性和细菌性角膜炎均有效。
