Therapeutic Effect of Corneal Crosslinking on Fungal Keratitis: Efficacy of Corneal Collagen Crosslinking as an Adjuvant Therapy for Fungal Keratitis in a Tertiary Eye Hospital in South India

To evaluate the efficacy of CXL in treating fungal keratitis as an adjuvant therapy. Detailed clinical examination microbiological investigation was performed. Twenty fungal keratitis patients were recruited and randomized into two groups: group 1 (n= 11, standard antifungal), group 2 (n=9, corneal...

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Published in:Ocular immunology and inflammation 2021-11, Vol.29 (7-8), p.1648-1655
Main Authors: Jeyalatha Mani, Vimalin, Parthasarathy, Durgadevi, Padmanabhan, Prema, Narayanan, Niveditha, Lakshmipathy, Meena, Pachayappan, Saravana Kumar, Jayavel, Padmapriya, Therese, Kulandhai Lily, Rao Madhavan, Hajib Narahari, Jambulingam, Malathi
Format: Article
Language:English
Subjects:
adjuvant therapy
Adult
Antifungal Agents - therapeutic use
Collagen - metabolism
Combined Modality Therapy
corneal collagen crosslinking
Corneal Stroma - drug effects
Corneal Stroma - metabolism
Corneal Ulcer - drug therapy
Corneal Ulcer - metabolism
Corneal Ulcer - microbiology
Cross-Linking Reagents - therapeutic use
cytokines
Cytokines - metabolism
Eye Infections, Fungal - drug therapy
Eye Infections, Fungal - metabolism
Eye Infections, Fungal - microbiology
Female
Fungal keratitis
Humans
India
Male
Middle Aged
Ophthalmology
Photochemotherapy - methods
Photosensitizing Agents - therapeutic use
Riboflavin - therapeutic use
Tertiary Care Centers
toll - like receptors
Toll-Like Receptors - metabolism
Treatment Outcome
Ultraviolet Rays
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Summary:To evaluate the efficacy of CXL in treating fungal keratitis as an adjuvant therapy. Detailed clinical examination microbiological investigation was performed. Twenty fungal keratitis patients were recruited and randomized into two groups: group 1 (n= 11, standard antifungal), group 2 (n=9, corneal collagen crosslinking with standard antifungal). Corneal scraping and tear samples collected were subjected to real-time PCR targeting ITS, TLR analysis and cytokine analysis. The mean time for complete resolution of ulcer for group 2 was significantly shorter compared to group 1 and the final mean BCVA was better for group 2. Expression of IL-1β, IL-8, IFN-γ significantly decreased immediately post CXL in group 2 patients. Significant downregulation of TLR 6, TLR-3, TLR-4 was observed 3-days post CXL compared to group 1 patients. Adjuvant effect of CXL was significant in treating fungal keratitis compared to standalone antifungal treatment.
ISSN:0927-3948
1744-5078
DOI:10.1080/09273948.2020.1770296