Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2022, Vol. 36 ›› Issue (5): 51-57.doi: 10.6040/j.issn.1673-3770.0.2021.303

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Clinical study of accelerated corneal collagen crosslinking in the treatment of fungal keratitis

WANG Xu, GAO Xin, ZHANG Yuguang   

  1. Department of Ophthalmology, Jinan Second People's Hospital, Jinan 250001, Shandong, China
  • Published:2022-09-20

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Abstract: Objective To evaluate the safety and effectivity of corneal collagen cross-linking(CXL)in the treatment of fungal keratitis. Methods In the experimental group, 92 patients(92 eyes)with “fungal keratitis” were treated with CXL from January 2017 to December 2019, whereas in the control group, clinical data of 47 patients(47 eyes)(control group)with fungal keratitis whoreceiveddrug treatment alone in our hospital from January 2016 to February 2017 were retrospectively analyzed. The inclusion criteria were as follows: lesion depth <2/3 of the corneal thickness,superficial corneal ulcer with a normal corneal thickness >400 μm, lesiondiameter between 3-6 mm, deviation or slight affectation of the pupil area due to the location of the lesion,fungi hyphae on confocal microscopy,and positive Fusarium resultson fungal culture. Therapeutic effects were compared and analyzed between the two groups. Results At 2 weeks postoperatively, the best corrected visual acuity significantly improved in the experimental group, showing a better treatment effect than that in the control group(P<0.001). At 3 months postoperatively, the best corrected visual acuity significantly improved as compared to preoperative findings, with a better treatment effect in the experimental group than that in the control group(P<0.001). In the experimental group, the lesion scope of all eyes remained stable orreduced after 2 weeks of treatment. At 3 months postoperatively, clouds were observed in the lesion area of all eyes with good epithelial healing. The positive rate of fungi was significantly lower in the experimental group than in the control group(P<0.001)at 2 weeks and 1 month postoperatively. During follow-up, all patients in the test group had no fungal recurrences and complications. Conclusion CXL is a safe and effective treatment for fungal keratitis cases with a small range and partial center, as it can significantly shorten the disease course and improve vision.

Key words: Corneal, Collagen crosslinking, Fungus, Keratitis, Fusarium

CLC Number: 

  • R779.6
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