The following is a summary of “Repeated sessions of PACK-CXL WA for the treatment of resistant bacterial keratitis: a retrospective study,” published in the July 2023 issue of Ophthalmology by Tawfeek et al.
Researchers conducted a retrospective study to evaluate the effectiveness and safety of repeated photo-activated chromophore for keratitis-cross linking (PACK-CXL) window absorption (WA) sessions for the treatment of resistant bacterial keratitis (BK).
The study included 30 eyes with failed epithelialization for 4 weeks after standard antimicrobial therapy (SAT) with PACK-CXL WA. After the initial PACK-CXL session with reduced ulcer size, stromal infiltrates, and epithelialization, another PACK-CXL WA session was done weekly until complete healing with negative bacterial culture. Micro-organism identification was made by lab study pre-and post-treatment. The healing of the cornea was assessed through both corneal examination and anterior segment OCT (AS-OCT).
The results showed 30 eyes of 30 patients (16 M, 14 F) with a mean age of 44.3 ± 5.38 years were included. The mean ulcer size was 3.96 ± 1.87 (mm3 and the stromal infiltrate size was 4.52 ± 2.24 mm3 PACK-CXL WA has performed an average of 2.87 times per eye. Successful treatment was observed in 90% (27 eyes) of cases, while failure of epithelialization was seen in 10% (3 eyes), with 90% of eyes healed by the second postoperative month.
They concluded that PACK-CXL WA is a non-invasive treatment for resistant BK, synergizing with SAT to overcome antibiotic resistance. Repeated sessions enhance epithelialization and resolution of BK.
Source: bmcophthalmol.biomedcentral.com/articles/10.1186/s12886-023-03080-3
