ROLE OF ACCELERATED CORNEAL CROSS-LINKING IN NON-HEALING MICROBIAL KERATITIS

Tuba Saman; Syed Fawad Rizvi; Sakshi Kumari; Rida Azeem; Zeeshan Kamil

doi:10.46903/gjms/23.4.Suppl.2051

ROLE OF ACCELERATED CORNEAL CROSS-LINKING IN NON-HEALING MICROBIAL KERATITIS

Tuba Saman, Syed Fawad Rizvi, Sakshi Kumari, Rida Azeem, Zeeshan Kamil

Abstract

Background: Non-healing microbial keratitis remains a significant threat to vision, particularly in low resource areas. Patients frequently experience delays in diagnosis and inadequate responses to standard treatments. Accelerated corneal cross linking is emerging as a promising approach to prevent irreversible blindness. The objective of this study was to evaluate the efficacy of accelerated corneal cross linking in managing non-healing microbial keratitis in a tertiary care setting.

Materials & Methods: In this prospective observational study, patients aged 18 to 70 with microbial keratitis who did not respond to antimicrobial treatment with in two weeks were included. All patients received accelerated corneal cross-linking (A-CXL) following a modified Dresden protocol. Data were collected on demographics, clinical characteristics, ulcer depth, culture results of microbes, outcomes and complications. Visual acuity (logMAR) was measured prior to the treatment, 1 month and 3 months after the surgery. IBM SPSS v-27 was used to analyze data. Paired t-test, repeated measures of ANOVA and chi-square was applied considering p-value ≤0.05 as significant.

Results: We enrolled 100 patients with mean age of 34.95±9.537 years. Most of the 65(65%) were males. The leading risk factor was 85(85%) ocular trauma while contact lens was reported by 50(50%). Bacterial infections were predominant. Ulcer reduction was significantly noted in 85(85%) cases, with 45(45%) cases requiring keratoplasty. Mean epithelial healing time occurred at 44.2±8.3 days. Visual acuity (logMAR) was noted 1.82±0.61 prior to treatment but it improved to 0.94±0.47 and 0.68±0.45 after one and three months. (p<0.001)

Conclusion: Corneal cross-linking is a safe and efficient adjunctive treatment that promotes ulcer resolution, vision recovery and symptom relief in cases of severe or treatment-resistant microbial keratitis. However, a significant number of patients still experience complications requiring additional procedures such as keratoplasty. The results encourage the adoption of accelerated corneal cross-linking in the management of saving vision.

Keywords

Corneal cross-linking; Corneal ulcer; Microbial keratitis; Keratoplasty; Visual Acuity.

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DOI: https://doi.org/10.46903/gjms/23.4.Suppl.2051