Corneal cross linking and infectious keratitis: a systematic review with a meta-analysis of reported cases.

Abstract

BACKGROUND:

Collagen 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.

RESULTS:

The 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.

CONCLUSION:

Although randomized controlled trials are needed, the available evidence supports the use of CXL in the treatment of infectious keratitis.

• Authors: Jorge L Alio, Alessandro Abbouda, David Diaz Valle, Jose M Benitez Del Castillo, Jose A Gegundez Fernandez
• Journal: Journal of ophthalmic inflammation and infection (J Ophthalmic Inflamm Infect) Vol. 3 Issue 1 Pg. 47 (May 29 2013) ISSN: 1869-5760 [Print] Germany
• PMID: 23718849 (Publication Type: Journal Article)