BackgroundCollagen cross linking (CXL) of the cornea has been developed recently as a new treatment for multidrug-resistant infectious keratitis. The aim of this study is to summarize the previously published data and evaluate the effectiveness of this treatment.ResultsThe search identified 12 articles. The number of eyes was 104. The infectious keratitis was associated with bacteria in 58 eyes (57f%): Gram-positive bacteria in 44 (43%; 4 of which were infected with Mycobacterium (3.6%)) and Gram-negative bacteria in 14 eyes (13%), fungus in 13 eyes (12%), and Acanthamoeba in 7 eyes (7%). In 26 eyes (25%), the microbiological culture was negative or not performed. The mean time of re-epithelization after CXL was 20.7±28.1 days (minimum of 3, maximum of 145). Sixteen eyes underwent deep or lamellar keratoplasty. The pooled analysis suggested that CXL has a favorable effect on the block of corneal melting in 85% (95%; CI 0.77, 0.91) of eyes.ConclusionAlthough randomized controlled trials are needed, the available evidence supports the use of CXL in the treatment of infectious keratitis.
0-10). Utilities were measured with the EuroQoL (EQ-5D utility ) (range 0-1). A time-integrated summary score defined the clinical effects (BASFI-AUC) and utilities (EQ-5D utility -AUC) over time. Both direct (health care and non-health care) and indirect costs were included. Resource utilisation and absence from paid work were registered weekly by the patients in a diary. All costs were calculated from a societal perspective. Results 111 patients completed the diary (group 1 n = 38; group 2 n = 36; control group n = 37). The between-group difference (95% CI) for the BASFI-AUC was 1.0 (0.4 to 1.6; p = 0.001) for group 1 versus controls, and 0.6 (0.1 to 1.1; p = 0.020) for group 2 versus controls. The between-group difference for the EQ-5D utility -AUC was 0.17 (0.09 to 0.25; p < 0.001) for group 1 versus controls, and 0.08 (0.00 to 0.15; p = 0.04) for group 2 versus controls. The mean total costs per patient (including costs for spa therapy) during the study period were ?3023 for group 1, ?3240 for group 2, and ?1754 for the control group. The incremental cost-effectiveness ratio was ? 1269 per unit effect gained in functional ability for group 1, and ?2477 for group 2. The costs per QALY gained were ?7465 for group 1 and ?18575 for group 2. Conclusion Combined spa-exercise therapy is more effective and shows favourable cost-effectiveness and cost-utility ratios compared to weekly group physical therapy alone in patients with ankylosing spondylitis.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.