Evaluation of the Therapeutic Effect of Corneal CXL in Treatment of Resistant Corneal Ulcer
Narrative Responses:
Purpose
To evaluate the therapeutic effect of corneal cross-linking (CXL) in 5 cases of resistant corneal ulcer.
Methods
5 eyes of 5 patients with resistant corneal ulcers failed to heal after maximal topical treatment underwent corneal collagen cross linking using ultraviolet rays A and transepithelial riboflavin. Preoperative and postoperative evaluation included slit lamp examination of the cornea, corneal pachymetry and visual acuity. The main outcome measures will be the improvement of epithelization, relieve of pain, improvement of the corneal stromal edema and improvement of visual acuity. Exclusion criteria were corneal thickness less than 400 um, topical treatment less than one month, impending corneal perforation and corneal melting.
Results
Three eyes of the 5 eyes showed improvement of re-epithelization up to complete healing of the ulcer and development of corneal opacification with relieve of ciliary injection, photophobia, pain, foreign body sensation and lacrimation. Also there was imporvemnt of corneal edema but visual acuity showed no remarkable improvement. Most of these results were obtained within 14 days post CXL. The remaining 2 eyes developed silimar results but after more than one month of CXL.
Conclusion
CXL should be considered as a new adjuvant therapeutic tool in patients with resistant corneal ulcer. Further studies on a large proportion of patients with longer follow up period should be done for accurate evaluation of this procedure.