Infectious keratitis is a potentially blinding disease, and some cases are challenging to treat, said Ashraf H. El Habbak, MD, PhD.
Although most cases are bacterial and resolve with topical broad-spectrum antibiotics, emerging antibiotic-resistant ulcers remain a threat, said Dr. El Habbak, professor, Department of Ophthalmology, Benha University, Egypt.
This has led to increased interest in the use of corneal crosslinking (CXL) to treat infectious keratitis, Dr. El Habbak said.
Corneal crosslinking is already used for keratoconus and other forms of corneal ectasia.
“Ultraviolet rays and topical riboflavin change the physiochemical properties of corneal collagen and by increasing its stiffness,” he said. “These changes increase the collagen resistance to the bacterial degradation enzymes.”
There are in vitro studies that address the efficacy of riboflavin and ultraviolet CXL against various pathogens, including methicillin-resistant Staphyloccocus aureus, multi drug-resistant Pseudomonas, and drug-resistant Streptococcus pneumoniae.
“However, clinical reports proving the efficacy of riboflavin UV/crosslinking in the treatment of microbial keratitis and arresting the corneal melts are still limited,” Dr. El Habbak said.