Comparison Between Three Different High Fluence Ultraviolet A Levels In Corneal
Collagen Cross-Linking For Treatment Of Experimentally Induced Fungal
Keratitis In Rabbits
Published 2022
- 40th Congress of the ESCRS
Reference: FPS10.01
| Type: Free paper
| DOI:
10.82333/ch05-9324
Authors:
Ramy Awad Mohamed Elbassiouny* 1
, Alaa Ghaith 2
, Ahmed Elmassry 1
, Manal Baddour 3
, Eman Sheta 4
, Farhad Hafezi 5
1Ophthalmology,Faculty of medicine, Alexandria University,Alexandria,Egypt, 2Faculty of medicine, Alexandria University,Alexandria,Egypt, 3Microbiology,Faculty of medicine, Alexandria University,Alexandria,Egypt, 4Pathology,Faculty of medicine, Alexandria University,Alexandria,Egypt, 5Ophthalmology,Faculty of Medicine, Geneva University,Geneva,Switzerland
Purpose
The aim of this study was to compare the efficacy of Photo-Activated Chromophore for Keratitis – Corneal Collagen Cross-linking (PACK-CXL) of three different total UVA fluence levels and topical voriconazole in treatment of fungal keratitis experimentally induced in rabbits
Setting
This is an interventional study conducted in the animal lab of Medical Research Institute, Alexandria University, Egypt, in collaboration with Ophthalmology, Microbiology and pathology departments of Alexandria Faculty of Medicine, Alexandria, Egypt. The study was approved by local animal research committee at Alexandria University, Alexandria, Egypt (No. 0201334- 03/2020)
Methods
This is an interventional experimental study including both eyes of 16 rabbits (32 eyes). Fungal keratitis was induced by intrastromal injection of Fusarium Solani into the cornea. The rabbits were then divided into four groups (8 eyes for each) from which group A received Voriconazole eye drops and considered as control group. Group B, C, D received single PACK-CXL session with total fluence levels of 7.2, 10.0 and 15.0 J/cm2 for each respectively. Daily clinical examination was recorded and all corneas were removed for microbiology and histopathology on day ten.
Results
The mean clinical signs score eyes treated with high fluence PACK-CXL showed evident clinical improvement from fourth to tenth day of treatment. This improvement was equivalent to that of Voriconazole treatment. The results showed better improvement with increasing the UVA total fluence levels but this difference was not statistically significant (P < 0.05). Similarly, the median CFU/ml declined on increasing UVA fluence but with no statistically significant values. Histopathological examination revealed better improvement of inflammatory signs on higher fluence levels compared to lower ones.
Conclusions
High intensity PACK-CXL (30 mW/cm2) was as effective as Voriconazole in the treatment of fungal keratitis in rabbits. Increasing the fluence of UVA was associated with slightly better clinical outcomes with no added risks. More clinical studies are needed to confirm these results.