title: The efficacy of corneal debridement in the treatment of microsporidial keratoconjunctivitis: a prospective randomized clinical trial.
abstract: OBJECTIVE
  To evaluate the efficacy of corneal debridement in the treatment of clinically diagnosed cases of microsporidial keratoconjunctivitis.
  
  
  METHODS
  Prospective, double-masked randomized clinical trial.
  
  
  METHODS
  Patients with clinical features such as multifocal, coarse, raised, punctate, round to oval epithelial lesions in the cornea in slit-lamp examination with mild to moderate conjunctival congestion, suggestive of microsporidial superficial keratoconjunctivitis, were included in the prospective study. All patients were randomized into 2 groups. Group 1 patients underwent debridement with the help of a sterile #15 blade on a Bard-Parker handle, whereas only conjunctival swabs were taken from Group 2 patients. All patients were treated with ocular lubricants.
  
  
  RESULTS
  One hundred and twenty patients with clinical features suggestive of microsporidial superficial keratoconjunctivitis were included in the study. The mean age was 34.3 ± 13.6 years (Group 1) and 35.8 ± 16.2 years (Group 2) (P = .59). The mean duration of symptoms was 6.8 ± 3.9 days (Group 1) and 7.2 ± 4.6 days (Group 2) (P = .61). Baseline characteristics showed no difference between the 2 groups. The primary outcome was the time from the presentation to complete resolution (ie, absence of corneal lesions) of the clinical signs and symptoms. The secondary outcomes were final visual acuity and residual corneal side effects and/or scarring, if any. The mean resolution time of the corneal lesions was 5.7 ± 4.0 days (Group 1) and 5.9 ± 3.9 days (Group 2) (P = .83). There was no significant difference in final visual outcome in the 2 groups. No serious side effects were observed.
  
  
  CONCLUSIONS
  Debridement does not have any significant advantage in terms of resolution of the corneal lesions and final visual outcome in cases of microsporidial keratoconjunctivitis.
authors.affiliation: Cornea and Anterior Segment Service, L. V. Prasad Eye Institute, Bhubaneswar, Odisha, India. Electronic address: sujatadas@lvpei.org.
authors.forename: Sujata
authors.initials: S
authors.lastname: Das
authors.affiliation: Cornea and Anterior Segment Service, L. V. Prasad Eye Institute, Bhubaneswar, Odisha, India.
authors.forename: Batriti S
authors.initials: BS
authors.lastname: Wallang
authors.affiliation: Ocular Microbiology Service, L. V. Prasad Eye Institute, Bhubaneswar, Odisha, India.
authors.forename: Savitri
authors.initials: S
authors.lastname: Sharma
authors.affiliation: Cornea and Anterior Segment Service, L. V. Prasad Eye Institute, Bhubaneswar, Odisha, India.
authors.forename: Yogesh V
authors.initials: YV
authors.lastname: Bhadange
authors.affiliation: Ocular Microbiology Service, L. V. Prasad Eye Institute, Bhubaneswar, Odisha, India.
authors.forename: Praveen K
authors.initials: PK
authors.lastname: Balne
authors.affiliation: Cornea and Anterior Segment Service, L. V. Prasad Eye Institute, Bhubaneswar, Odisha, India.
authors.forename: Srikant K
authors.initials: SK
authors.lastname: Sahu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003646:Debridement / Q000009:adverse effects / Q000379:methods*; D004311:Double-Blind Method; D015821:Eye Infections, Fungal / Q000382:microbiology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007637:Keratoconjunctivitis / Q000382:microbiology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008828:Microbiological Techniques; D008856:Microscopy, Fluorescence; D016816:Microsporida / Q000302:isolation & purification*; D016881:Microsporidiosis / Q000382:microbiology / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult