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Priya Basaiawmoit, Satheesh Solomon T Selvin, Sanita Korah
PURPOSE: To assess the usefulness of photoactivated chromophore for infectious keratitis-corneal collagen cross-linking in reducing the time to heal in suppurative corneal ulcers in a South Indian tertiary care center. METHODS: This was an observational cohort study with 2 arms. In the prospective arm, 13 patients with suppurative corneal ulcers who presented to the outpatient department were recruited. Their ulcers were exposed to ultraviolet-A with riboflavin (B2) (photoactivated chromophore for infectious keratitis-corneal collagen cross-linking) up to a maximum of 4 sittings at 3-day intervals...
June 14, 2018: Cornea
R Atia, L Jouve, J Knoeri, C Georgeon, L Laroche, V Borderie, N Bouheraoua
Infectious keratitis are a frequent cause of ocular morbidity. Today, new treatments are necessary to combat the emergence of antibiotic resistant germs. Corneal collagen cross-linking has been suggested to treat corneal infectious (PACK-CXL). Its action would be both antimicrobial and protective for the cornea, increasing its biochemical resistence to proteolytic enzymes. In vivo, PACK-CXL might demonstrate good efficacy against bacterial keratitis, contrary to herpetic keratitis for which it is contraindicated...
June 11, 2018: Journal Français D'ophtalmologie
Hüseyin Baran Özdemir, Ayşe Kalkancı, Kamil Bilgihan, Pınar Uyar Göçün, Betül Öğüt, Funda Karakurt, Merve Erdoğan
PURPOSE: To compare the antifungal efficacy of corneal collagen cross-linking with photoactivated riboflavin (PACK-CXL) and voriconazole in experimental Fusarium solani and Candida albicans keratitis models. METHODS: Sixty-four corneas of 32 New Zealand rabbits were included and divided into two main groups. Intrastromal injection of Fusarium and Candida suspensions was performed, and it was observed that keratitis was formed on the third day. Both groups were randomly separated into the following four groups: control, PACK-CXL, voriconazole and PACK-CXL combined with voriconazole...
June 4, 2018: Acta Ophthalmologica
Boris Knyazer, Yonit Krakauer, Yael Baumfeld, Tova Lifshitz, Sabine Kling, Farhad Hafezi
PURPOSE: To evaluate the effect of accelerated corneal cross-linking with photoactivated chromophore (PACK-CXL) as additional treatment for therapy-resistant infectious keratitis. METHODS: In this interventional cohort study, 20 patients (11 men and 9 women), aged 65.5 (interquartile range = 21.5-78.5) years, who were hospitalized for moderate-sized therapy-resistant bacterial corneal ulcers (11/20 microbiologically confirmed) were treated with hypoosmolar 0.1% riboflavin solution and Ultraviolet A (UVA) irradiation for 3 minutes at 30 mW/cm (5...
April 2018: Cornea
Ayse Kalkanci, Kamil Bilgihan, Huseyin Baran Ozdemir, Atiye Seda Yar Saglam, Funda Karakurt, Merve Erdogan
The aim of our study was to investigate matrix metalloproteinases, MMP-9 and MMP-13 levels, in the rabbit model of Fusarium and Candida keratitis treated by corneal cross-linking (PACK-CXL). Rabbit corneas were inoculated with fungal inoculum for keratitis. Each group divided into four subgroups, including un-treated group, PACK-CXL group, voriconazole group and PACK-CXL plus voriconazole group. PACK-CXL was applied with 0.25% riboflavin in accelerated Dresden protocol, and 0.1% voriconazole drops were administered...
April 2018: Mycopathologia
Priyanka Mandal, Mohammad A Khan, Sunil Shah
Natural products have been in use long before the introduction of modern drug therapies and are still used in various communities worldwide for the treatment of anterior eye disease. The aim of this review is to look at the current non-pharmaceutical modalities that have been tried and assess the body of existing evidence behind them. This includes alternative medicine, existing non-pharmaceutical therapy and more recent low and high tech solutions. A detailed search of all available databases including MEDLINE, Pubmed and Google was made to look for English-language studies for complementary and alternative treatment modalities (CAM), natural therapies and new modalities for anterior eye disease such as blepharitis, dry eye and microbial keratitis...
December 2017: Contact Lens & Anterior Eye: the Journal of the British Contact Lens Association
Tommy C Y Chan, Vanissa W S Chow, Vishal Jhanji
PURPOSE: To report a case of infectious keratitis after small incision lenticule extraction (SMILE) treated with collagen cross-linking with photoactivated riboflavin (PACK-CXL). METHODS: Case report and literature review. RESULTS: A patient presented with culture-proven bacterial keratitis 5 days after SMILE was treated with fortified topical antibiotics and PACK-CXL. Irrigation of the corneal cap-stromal bed interface, which can be difficult and affect visual outcomes, was not performed...
April 1, 2017: Journal of Refractive Surgery
Jawaher M Alshehri, David Caballero-Lima, M Chantal Hillarby, Susan G Shawcross, Arun Brahma, Fiona Carley, Nick D Read, Hema Radhakrishnan
Purpose: Some previous reports have established the use of photoactivated chromophore-induced corneal cross-linking (PACK-CXL) in treating fungal keratitis. The results of these case reports have often been conflicting. To systematically study the effect of PACK-CXL in the management of Fusarium keratitis, we have developed an ex vivo model of human corneal infection using eye-banked human corneas. Methods: Sixteen healthy ex vivo human corneas were divided into four study groups: (1) untreated control, (2) cross-linked, (3) infected with fungal spores, and (4) infected with fungal spores and then cross-linked...
November 1, 2016: Investigative Ophthalmology & Visual Science
David Tabibian, Cosimo Mazzotta, Farhad Hafezi
BACKGROUND: Corneal cross-linking (CXL) using ultraviolet light-A (UV-A) and riboflavin is a technique developed in the 1990's to treat corneal ectatic disorders such as keratoconus. It soon became the new gold standard in multiple countries around the world to halt the progression of this disorder, with good long-term outcomes in keratometry reading and visual acuity. The original Dresden treatment protocol was also later on used to stabilize iatrogenic corneal ectasia appearing after laser-assisted in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK)...
2016: Eye and Vision (London, England)
A Abbouda, I Abicca, J L Alió
PURPOSE: To review the application of the PACK-CXL and to identify different treatment protocols according to the pathogens associated with keratitis. METHODS: A systematic review of 21 articles. The primary outcome was the healing of a corneal ulcer, defined as epithelization, blocking corneal melting. The secondary end-point was the recovery of visual acuity. RESULTS: We studied a total of 145 eyes. Infectious keratitis was associated with bacteria in 80 eyes (55...
April 19, 2016: Seminars in Ophthalmology
Ngamjit Kasetsuwan, Usanee Reinprayoon, Vannarut Satitpitakul
PURPOSE: To evaluate the efficacy of photoactivated chromophore for infectious keratitis (PACK-CXL) in the treatment of patients with moderate to severe infectious keratitis as adjunct therapy to the topical medication treatment. DESIGN: Randomized clinical trial. METHODS: Thirty eyes from 30 patients with moderate to severe infectious keratitis were randomized to receive either standard treatment plus PACK-CXL (n = 15) or standard treatment alone (control group, n = 15)...
May 2016: American Journal of Ophthalmology
Karim Makdoumi, Anders Bäckman
BACKGROUND: To evaluate the bactericidal effect of clinical ultraviolet A (UVA) settings used in photoactivated chromophore for infectious keratitis (PACK)-collagen cross-linking (CXL) in antibiotic-resistant and non-resistant bacterial strains. METHODS: Well-characterized bacterial strains from clinical isolates, without and with antibiotic resistance, were studied in a pairwise comparison. The evaluated pathogens were Staphylococcus epidermidis, Staphylococcus aureus, Pseudomonas aeruginosa, and Enterococcus faecalis...
September 2016: Clinical & Experimental Ophthalmology
Kamil Bilgihan, Ayse Kalkanci, Huseyin Baran Ozdemir, Reyhan Yazar, Funda Karakurt, Erdem Yuksel, Feza Otag, Nilgun Karabicak, Sevtap Arikan-Akdagli
PURPOSE: Antifungal efficacy of photochemical cross-linking (PACK-CXL) with 0.1% and 0.25% riboflavin was evaluated with a comparative in vitro study. METHODS: Candida albicans and Aspergillus fumigatus ATCC reference strains, Candida parapsilosis, Aspergillus fumigatus, Fusarium solani, Scedosporium apiospermum, and Alternaria alternata strains isolated from keratitis cases were chosen as targeted microorganisms. Unique "black plate method" was developed in polystyrene microplates...
August 2016: Current Eye Research
(no author information available yet)
No abstract text is available yet for this article.
October 2015: Journal of Refractive Surgery
Kfir Tal, Orly Gal-Or, Shani Pillar, Alon Zahavi, Oded Rock, Irit Bahar
PURPOSE: To evaluate the efficacy of corneal collagen cross-linking (CXL) with photoactivated riboflavin (PACK-CXL) as primary therapy for Staphylococcus aureus-induced corneal ulcers in a rabbit model. METHODS: The right eye of 40 rabbits was inoculated with S. aureus to induce formation of central corneal ulcers (day 1). The ulcer was examined on day 5, and rabbits were randomly assigned to 4 groups-group A: no treatment (control); group B: topical antibiotic treatment (cefazolin 50 mg/mL, garamycin 14 mg/mL drops, chloramphenicol 5% ointment every 2 hours); group C: PACK-CXL; group D: PACK-CXL + topical antibiotics...
October 2015: Cornea
David Tabibian, Olivier Richoz, Farhad Hafezi
This article discusses corneal cross-linking (CXL) and how it transitioned from a modality for treating corneal ectatic disorders to an inventive means of treating infectious keratitis. Initially, CXL was successfully developed to halt the progression of ectatic diseases such as keratoconus, using the standard Dresden protocol. Later, indications were extended to treat iatrogenic ectasia developing after laser-assisted in situ keratomileusis (LASIK) and photo-refractive keratectomy (PRK). At the time, it had been postulated that the combination of ultraviolet light with riboflavin could not only biomechanically strengthen the cornea but also was capable of destroying living cells and organisms including keratocytes and pathogens...
January 2015: Journal of Ophthalmic & Vision Research
David Tabibian, Olivier Richoz, Arnaud Riat, Jacques Schrenzel, Farhad Hafezi
PURPOSE: To report the use of accelerated photoactivated chromophore for keratitis-corneal collagen cross-linking (PACK-CXL) as a first-line treatment in a patient with an atypical fungal keratitis. METHODS: Case report and literature review. RESULTS: A patient who presented with a painful peripheral corneal infiltrate underwent PACK-CXL with a local limited abrasion and accelerated ultraviolet-A irradiation at 365 μm and 9 mW/cm² for 10 minutes...
December 2014: Journal of Refractive Surgery
Olivier Richoz, Sabine Kling, Florence Hoogewoud, Arthur Hammer, David Tabibian, Patrice Francois, Jacques Schrenzel, Farhad Hafezi
PURPOSE: To investigate whether optimized photoactivated chromophore for keratitis-corneal collagen cross-linking (PACK-CXL) treatment settings allow accelerating treatment while maintaining antibacterial efficacy. METHODS: Staphylococcus aureus and Pseudomonas aeruginosa strains were irradiated with ultraviolet-A light of equal fluence but different intensity settings (18 mW/cm² for 5 minutes and 36 mW/cm² for 2.5 minutes). The killing rate was determined by comparing the number of colony-forming units between cross-linked specimens and non-irradiated controls...
December 2014: Journal of Refractive Surgery
Farhad Hafezi, J Bradley Randleman
No abstract text is available yet for this article.
July 2014: Journal of Refractive Surgery
Myriam Cassagne, Camille Laurent, Magda Rodrigues, Anne Galinier, Eberhard Spoerl, Stéphane D Galiacy, Vincent Soler, Pierre Fournié, François Malecaze
PURPOSE: We compared an iontophoresis riboflavin delivery technique for transepithelial corneal collagen crosslinking (I-CXL) with a conventional CXL (C-CXL). METHODS: We designed three experimental sets using 152 New Zealand rabbits to study riboflavin application by iontophoresis using charged riboflavin solution (Ricrolin+) with a 1-mA current for 5 minutes. The first set was to compare riboflavin concentration measured by HPLC in corneas after iontophoresis or conventional riboflavin application...
February 2016: Investigative Ophthalmology & Visual Science
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