title: Established and emerging ancillary techniques in management of microbial keratitis: a review.
abstract: Microbial keratitis is a sight-threatening condition and an ocular emergency, because of the potential for rapid progression. Intensive topical antimicrobials are the mainstay and the gold standard of treatment for microbial keratitis. However, despite appropriate diagnosis and therapy, treatment failure is still common, and can result in significant morbidity due to corneal perforation and/or scarring. For this reason, clinicians continue to seek novel treatment techniques in order to expand the armamentarium of tools available to manage microbial keratitis, and in doing so improve clinical outcomes. In this review, we examine the evidence for some established, as well as a few emerging ancillary techniques used to manage microbial keratitis. These include topical corticosteroids, corneal collagen cross-linking, intrastromal antimicrobials, amniotic membrane transplantation and miscellaneous other techniques. Of these, collagen cross-linking shows some promise for selected cases of infectious keratitis, although more research in the area is required before it is accepted as mainstream treatment for this potentially blinding condition.
authors.affiliation: Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia Department of Ophthalmology, Westmead Hospital, Sydney, New South Wales, Australia Westmead Millennium Institute for Medical Research, Westmead, New South Wales, Australia.
authors.forename: Dana
authors.initials: D
authors.lastname: Robaei
authors.affiliation: Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Nicole
authors.initials: N
authors.lastname: Carnt
authors.affiliation: Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia Corneal Unit, Sydney Eye Hospital, Sydney, New South Wales, Australia.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Watson
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001684:Biological Dressings; D015818:Eye Infections, Bacterial / Q000628:therapy*; D006801:Humans; D007634:Keratitis / Q000628:therapy*; D010778:Photochemotherapy / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: Cornea; Infection; Ocular surface; Treatment other