Evaluation of the therapeutic effect of corneal collagen cross-linking in the treatment of resistant corneal ulcer

Abstract

PurposeThe aim of this study was to evaluate the therapeutic results of corneal collagen cross-linking (CXL) in terms of safety and efficacy in the treatment of resistant corneal ulcer.DesignThis study was designed as a noncomparative prospective clinical trial.Patients and methodsFive eyes of five patients with resistant corneal ulcers that failed to heal after maximal topical treatment underwent CXL using UVA rays and transepithelial riboflavin. Preoperative and postoperative evaluation included slit-lamp examination of the cornea, corneal pachymetry, and visual acuity. Postoperative outcome included the degree of improvement of epithelization, relief of pain, disappearance of the corneal stromal edema, and improvement in visual acuity. Exclusion criteria were corneal thickness less than 400 μm, topical treatment less than 1 month, and impending corneal perforation or melting.ResultsThree eyes of the five eyes showed improvement in re-epithelization up to complete healing of the ulcer and development of corneal opacification with relief of ciliary injection, photophobia, pain, foreign body sensation, and lacrimation. Also, there was an improvement in corneal edema, but visual acuity showed no remarkable improvement. Most of these results were observed within 14 days after CXL. The remaining two eyes showed similar results, but after more than 1 month of CXL.ConclusionThis study proved that CXL is a beneficial therapeutic procedure for healing of resistant corneal ulcers. Also, CXL seems to be a safe and effective method for healing of resistant corneal ulcers. Further studies on a large proportion of patients with a longer follow-up period are recommended.