title: Photoactivated Chromophore for Moderate to Severe Infectious Keratitis as an Adjunct Therapy: A Randomized Controlled Trial.
abstract: OBJECTIVE
  To evaluate the efficacy of photoactivated chromophore for infectious keratitis (PACK-CXL) in the treatment of patients with moderate to severe infectious keratitis as adjunct therapy to the topical medication treatment.
  
  
  METHODS
  Randomized clinical trial.
  
  
  METHODS
  Thirty eyes from 30 patients with moderate to severe infectious keratitis were randomized to receive either standard treatment plus PACK-CXL (n = 15) or standard treatment alone (control group, n = 15). The primary outcome was the sizes of stromal infiltrates measured on slit-lamp photographs 30 days after treatment. The secondary outcomes were the sizes of epithelial defects, the complication rates, and best pinhole-corrected visual acuity (BPVA).
  
  
  RESULTS
  The median (interquartile range [IQR]) sizes of stromal infiltrates at day 30 were 5.0 mm(2) (0-23.0 mm(2)) in the PACK-CXL group and 10.6 mm(2) (1.1-16.3 mm(2)) in the control group (median difference 0, 95% CI -7.0 to 0, P = .66). The median (IQR) sizes of epithelial defects were 0.7 mm(2) (0-6.3 mm(2)) and 4.6 mm(2) (0-10.2 mm(2)) in the PACK-CXL group and control group, respectively (median difference -3.0, 95% CI -0.8 to 0, P = .41). The complication rates and BPVA after treatment were comparable between groups.
  
  
  CONCLUSIONS
  Standard treatment combined with PACK-CXL did not provide any advantageous effect over standard treatment alone in moderate to severe infectious keratitis over a 30-day period.
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
authors.forename: Ngamjit
authors.initials: N
authors.lastname: Kasetsuwan
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
authors.forename: Usanee
authors.initials: U
authors.lastname: Reinprayoon
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, and King Chulalongkorn Memorial Hospital, Bangkok, Thailand. Electronic address: vannaruts@gmail.com.
authors.forename: Vannarut
authors.initials: V
authors.lastname: Satitpitakul
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D000583:Amikacin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002437:Cefazolin / Q000627:therapeutic use; D003094:Collagen / Q000378:metabolism; D003131:Combined Modality Therapy; D003319:Corneal Stroma / Q000378:metabolism; D003320:Corneal Ulcer / Q000188:drug therapy* / Q000378:metabolism / Q000382:microbiology; D003432:Cross-Linking Reagents; D015818:Eye Infections, Bacterial / Q000188:drug therapy* / Q000378:metabolism / Q000382:microbiology; D015821:Eye Infections, Fungal / Q000188:drug therapy* / Q000378:metabolism / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D012256:Riboflavin / Q000627:therapeutic use; D014466:Ultraviolet Rays; D014792:Visual Acuity; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D000583:Amikacin; D003094:Collagen; D002437:Cefazolin; D012256:Riboflavin