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pack-cxl keratitis

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
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...
December 7, 2015: Current Eye Research
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
Dalia G Said, Mohamed S Elalfy, Zisis Gatzioufas, Ehab S El-Zakzouk, Mansour A Hassan, Mohamed Y Saif, Ahmed A Zaki, Harminder S Dua, Farhad Hafezi
PURPOSE: To investigate the efficacy and safety of corneal collagen cross-linking (CXL) with photoactivated riboflavin (photoactivated chromophore for infectious keratitis [PACK]-CXL) in the management of infectious keratitis with corneal melting. DESIGN: Prospective clinical trial. PARTICIPANTS: Forty eyes from 40 patients with advanced infectious keratitis and coexisting corneal melting. METHODS: Twenty-one patients (21 eyes) underwent PACK-CXL treatment in addition to antimicrobial therapy...
July 2014: Ophthalmology
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