Corneal collagen cross-linking window absorption.
OBJECTIVE
To evaluate the safety and efficacy of treatment of severe infectious corneal ulcers with hypoosmolar riboflavin solution and UV-A collagen cross-linking (CXL) without deepithelizing the cornea.


METHODS
Four eyes of 3 patients with severe keratitis and associated corneal melting, were treated with a new protocol of corneal CXL for infectious keratitis, named cross-linking window absorption (CXL-WA). CXL-WA was performed when the infection did not respond to systemic and topical antibiotic therapy. The protocol entails the use of hypoosmolar riboflavin before the irradiation with UV-A, and the penetration is obtained through the epithelial defect overlying the ulcer.


RESULTS
In all cases, CXL halted the progression of the ulcer. After a minimum follow-up of 3 months, none of the patients had recurrence of the infection.


CONCLUSIONS
CXL-WA is a promising technique of treatment of infectious corneal ulcers, delaying or preventing more invasive approaches.
Department of Ophthalmology, Istituto Clinico Humanitas, Milan, Italy.
Pietro
P
Rosetta
Riccardo
R
Vinciguerra
Mario R
MR
Romano
Paolo
P
Vinciguerra
D000293:Adolescent; D000368:Aged; D003320:Corneal Ulcer / Q000188:drug therapy*; D003432:Cross-Linking Reagents / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000009:adverse effects / Q000627:therapeutic use*; D012256:Riboflavin / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D012256:Riboflavin