Microbiologic, Pharmacokinetic, and Clinical Effects of Corneal Collagen Cross-Linking on Experimentally Induced Pseudomonas Keratitis in Rabbits

Cosar, C; Küçük, Mutlu; Çelik, Ekrem Şanver; Gönen, Tansu; Akyar, Işın; Serteser, Mustafa; Tokat, Fatma; Ince, Umit

doi:10.1097/ico.0000000000000516

Cited by 13 publications

(10 citation statements)

References 27 publications

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“…The authors concluded that CXL had a positive effect both as stand‐alone treatment and in combination with medical therapy. In contrast, Cosar et al did not observe a significant or positive effect of CXL treatment alone on colony‐forming unit counts and ulcer scores in rabbits with Pseudomonas‐infected ulcers, whereas the greatest post‐treatment reduction in ulcer scores was seen when CXL and medical treatment were combined.…”

Section: Discussionmentioning

confidence: 86%

Corneal cross‐linking (CXL)—A clinical study to evaluate CXL as a treatment in comparison with medical treatment for ulcerative keratitis in horses

Edman

Ström

Ekesten

2019

Veterinary Ophthalmology

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Objective Compare CXL treatment with medical treatment alone in horses with stromal, ulcerative keratitis. Animals studied: 24 horses (24 eyes) with stromal, ulcerative keratitis were included. Procedure 12 horses were initially treated with CXL, and 12 horses were given conventional medical treatment. Topical medical treatment was added to horses in the CXL group if necessary. Parameters including cytology, microbial growth, time to fluorescein negativity, and time to inhibition of stromal melting were evaluated. Results After the first day of treatments, a decrease in inflammatory signs and pain from the eye was observed in both groups. Stromal melting ceased within 24 hours regardless of treatment. CXL treatment alone was sufficient in 3 horses with noninfectious, superficial stromal ulcerations. Clinical signs of impaired wound healing were seen after 3‐14 days in corneas with suspected or proven bacterial infection treated with CXL only, most likely because of insufficient elimination of bacteria deeper in the corneal stroma or because of re‐infection from bacteria in the conjunctiva. The average decrease in stromal ulcer area per day after onset of treatment was almost identical between the groups, and no significant difference in time to fluorescein negativity was found. Conclusions We consider CXL a possible useful adjunct treatment of corneal stromal ulcers in horses, especially for melting ulcers and as a potential alternative to prophylactic antibiotic treatment for noninfected stromal ulcers. However, CXL should not be used alone for infected or suspected infected stromal ulcers, because topical antibiotics were required in all horses with proven infectious keratitis.

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Section: Discussionmentioning

confidence: 86%

Corneal cross‐linking (CXL)—A clinical study to evaluate CXL as a treatment in comparison with medical treatment for ulcerative keratitis in horses

Edman

Ström

Ekesten

2019

Veterinary Ophthalmology

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“…studied the effects of CXL on the penetration of topical 0.5% moxifloxacin, number of colony-forming units (CFUs), and the clinical course of infection in Pseudomonas aeruginosa rabbit keratitis model. [23] Although there was a significant difference in the clinical improvement between moxifloxacin group and moxifloxacin with CXL group, there was no difference in CFU counts between two groups. Authors concluded that the synergistic effect of CXL as reflected by clinical cure in the treatment of corneal ulcer is not just through enhanced antibiotic penetrance or efficacy.…”

Section: Are These Results Translated In In Iivo Animal Experiments?mentioning

confidence: 99%

Collagen cross-linking for microbial keratitis

Garg

Das

Roy

2017

Middle East Afr J Ophthalmol

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“…Over the last decade, attempts have been made to treat refractory cases of infectious keratitis with new medications and technologies, one such being PACK-CXL. Both in vitro and in vivo studies have shown microbial inhibition of Pseudomonas aeruginosa , 16 , 17 , 18 Mycobacterium chenolae, 12 and filamentous fungi with CXL treatment. 19 …”

Section: Discussionmentioning

confidence: 99%

Long-term outcomes of riboflavin photodynamic antimicrobial therapy as a treatment for infectious keratitis

Martínez

Arboleda

Naranjo

et al. 2019

American Journal of Ophthalmology Case Reports

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Purpose To report the long-term outcomes of three patients with infectious keratitis treated with riboflavin photodynamic antimicrobial therapy (PDAT). Observations Case series reporting three patients with infectious keratitis unresponsive to standard medical treatment who underwent riboflavin photodynamic antimicrobial therapy (PDAT) as an adjunct therapy. One male and two female patients were treated, the median age of presentation was 58 years (range, 29–79 years). The organisms isolated and treated were Pseudomonas aeruginosa , Mycobacterium chenolae , and Curvularia spp. Different risk factors to develop corneal infection ulcers were identified, including corneal abrasion in a contact lens user, history of penetrating keratoplasty with chronic use of topical corticosteroids, and organic trauma. The median follow-up was 47 months (range 37–54 months), and there were no complications secondary to riboflavin PDAT treatment. Two cases underwent optical penetrating keratoplasty after infection was resolved and ocular surface was quiet for at least 3 years. Conclusions and importance Riboflavin PDAT can be used as an adjunct treatment in infectious keratitis to strengthen the corneal collagen fibers, delay keratolysis, and allow more time for antimicrobials to work and this way prevent a corneal perforation.

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Microbiologic, Pharmacokinetic, and Clinical Effects of Corneal Collagen Cross-Linking on Experimentally Induced Pseudomonas Keratitis in Rabbits

Abstract: Clinical improvement was greatest in the MOX + CXL group. The synergistic effect of CXL on corneal ulcer treatment is not through antibiotic penetrance.

Cited by 13 publications

References 27 publications

Corneal cross‐linking (CXL)—A clinical study to evaluate CXL as a treatment in comparison with medical treatment for ulcerative keratitis in horses

Corneal cross‐linking (CXL)—A clinical study to evaluate CXL as a treatment in comparison with medical treatment for ulcerative keratitis in horses

Collagen cross-linking for microbial keratitis

Long-term outcomes of riboflavin photodynamic antimicrobial therapy as a treatment for infectious keratitis

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