title: Corneal collagen cross-linking and liposomal amphotericin B combination therapy for fungal keratitis in rabbits.
abstract: OBJECTIVE
  To observe the therapeutic effect of corneal collagen cross-linking (CXL) in combination with liposomal amphotericin B in fungal corneal ulcers.
  
  
  METHODS
  New Zealand rabbits were induced fungal corneal ulcers by scratching and randomly divided into 3 groups,i.e.control, treated with CXL, and combined therapy of CXL with 0.25% liposomal amphotericin B (n=5 each). The corneal lesions were documented with slit-lamp and confocal microscopy on 3, 7, 14, 21 and 28d after treatment. The corneas were examined with transmission electron microscopy (TEM) at 4wk.
  
  
  RESULTS
  A rabbit corneal ulcer model ofFusariumwas successfully established. The corneal epithelium defect areas in the two treatment groups were smaller than that in the control group on 3, 7, 14 and 21d (P<0.05). The corneal epithelium defect areas of the combined group was smaller than that of the CXL group (P<0.05) on 7 and 14d, but there were no statistical differences on 3, 21 and 28d. The corneal epithelium defects of the two treatment groups have been healed by day 21. The corneal epithelium defects of the control group were healed on 28d. The diameters of the corneal collagen fiber bundles (42.960±7.383 nm in the CXL group and 37.040±4.160 nm in the combined group) were thicker than that of the control group (24.900±1.868 nm), but there was no difference between the two treatment groups. Some corneal collagen fiber bundles were distorted and with irregular arrangement, a large number of fibroblasts could be seen among them but no inflammatory cells in both treatment groups.
  
  
  CONCLUSIONS
  CXL combined with liposomal amphotericin B have beneficial effects on fungal corneal ulcers. The combined therapy could alleviate corneal inflammattions, accelerate corneal repair, and shorten the course of disease.
authors.affiliation: Department of Ophthalmology, the First Hospital of Xi'an, Shaanxi Ophthalmological Institute, Xi'an 710002, Shaanxi Province, China.
authors.forename: Zhao-Qin
authors.initials: ZQ
authors.lastname: Hao
authors.affiliation: Department of Ophthalmology, the First Hospital of Xi'an, Shaanxi Ophthalmological Institute, Xi'an 710002, Shaanxi Province, China.
authors.forename: Jin-Xin
authors.initials: JX
authors.lastname: Song
authors.affiliation: Department of Ophthalmology, the First Hospital of Xi'an, Shaanxi Ophthalmological Institute, Xi'an 710002, Shaanxi Province, China.
authors.forename: Shi-Yin
authors.initials: SY
authors.lastname: Pan
authors.affiliation: Department of Ophthalmology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Ophthalmology, the First Hospital of Xi'an, Shaanxi Ophthalmological Institute, Xi'an 710002, Shaanxi Province, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Cheng
authors.affiliation: Department of Ophthalmology, the First Hospital of Xi'an, Shaanxi Ophthalmological Institute, Xi'an 710002, Shaanxi Province, China.
authors.forename: Xian-Ning
authors.initials: XN
authors.lastname: Liu
authors.affiliation: Department of Ophthalmology, the First Hospital of Xi'an, Shaanxi Ophthalmological Institute, Xi'an 710002, Shaanxi Province, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Wu
authors.affiliation: Department of Ophthalmology, the First Hospital of Xi'an, Shaanxi Ophthalmological Institute, Xi'an 710002, Shaanxi Province, China.
authors.forename: Xiang-Hua
authors.initials: XH
authors.lastname: Xiao
authors.affiliation: Department of Ophthalmology, the First Hospital of Xi'an, Shaanxi Ophthalmological Institute, Xi'an 710002, Shaanxi Province, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Gao
authors.affiliation: Department of Ophthalmology, the First Hospital of Xi'an, Shaanxi Ophthalmological Institute, Xi'an 710002, Shaanxi Province, China.
authors.forename: Hai-Feng
authors.initials: HF
authors.lastname: Zhu
keywords: confocal microscope; corneal collagen cross-linking; fungal keratitis; liposomal amphotericin B; rabbit