Crasta Manuela, Gimenez Eva, Ostan Pier Carlo, Arteaga Kevin
Visionvet Anicura Eye Clinic, Bologna, Italy.
Vet Ophthalmol. 2025 Mar;28(2):413-424. doi: 10.1111/vop.13284. Epub 2024 Oct 25.
To evaluate the success and failure rate of photoactivated chromophore for keratitis-corneal cross-linking (PACK-CXL) therapy in a single population of dogs and cats. To identify the usefulness of the PACK-CXL based on ulcer depth and establish a cutoff at which this procedure could be recommended. To analyze the influence of the different variables in corneal healing time and to report the presence of secondary endothelial damage and cataract formation.
Medical records of dogs and cats with presumptive infectious keratitis which underwent accelerated epithelium-off PACK-CXL between 2016 and 2023 were reviewed and analyzed.
Records for 369 animals were included, and the overall success rate for healing was 97% (range 4-74 days and no rescue procedure). The second success (re-epithelialization <30 days and no rescue procedure) rate was 86%, and a total of 40 eyes needed more than 1 month for the corneal repair. Corneal ulcers were classified in three categories based on the depth: 0%-33% (46%), 34%-66% (37.4%), and 67%-100% (16.5%). The cutoff at which PACK-CXL had a higher probability of failure was with ulcer depth >66.5%. Animals who suffered from keratomalacia and hypopyon at presentation, or were treated with topical serum or gentamicin after PACK-CXL showed an increase in epithelial healing time (EHT). Increasing age, brachycephalic conformation, keratomalacia alone, and deeper ulcers were identified as risk factors for the treatment outcome. Secondary endothelial injury or cataract formation was not noted in this study.
Accelerated PACK-CXL is a non-invasive, adjunctive treatment to medical therapy, which can be used in presumed infectious keratitis with a high probability of success. However, it is important to take in consideration the patient age, skull conformation, presence of keratomalacia, and the ulcer depth.
评估光活化色团用于犬猫角膜炎-角膜交联（PACK-CXL）治疗在单一犬猫群体中的成功率和失败率。根据溃疡深度确定PACK-CXL的有效性，并确定可推荐该手术的临界值。分析不同变量对角膜愈合时间的影响，并报告继发性内皮损伤和白内障形成的情况。
回顾并分析了2016年至2023年间接受加速上皮剥脱PACK-CXL治疗的疑似感染性角膜炎犬猫的病历。
纳入了369只动物的记录，总体愈合成功率为97%（范围为4 - 74天，无需挽救手术）。二次成功率（重新上皮化<30天且无需挽救手术）为86%，共有40只眼睛的角膜修复需要超过1个月时间。角膜溃疡根据深度分为三类：0% - 33%（46%）、34% - 66%（37.4%）和67% - 100%（16.5%）。PACK-CXL失败概率较高的临界值是溃疡深度>66.5%。就诊时患有角膜软化症和前房积脓，或在PACK-CXL后接受局部血清或庆大霉素治疗的动物，其上皮愈合时间（EHT）延长。年龄增加、短头畸形、单纯角膜软化症和更深的溃疡被确定为治疗结果的危险因素。本研究未发现继发性内皮损伤或白内障形成。
加速PACK-CXL是一种非侵入性的辅助治疗方法，可用于疑似感染性角膜炎，成功率较高。然而，考虑患者年龄、颅骨形态、角膜软化症的存在以及溃疡深度很重要。
