Photo-Activated Riboflavin Therapy of Refractory Corneal Ulcers

Abstract

To evaluate the therapeutic effect of photo-activated riboflavin (PAR) for treating refractory corneal ulcers. Seven eyes with infectious keratitis, presented with a gradually deteriorating, vision-threatening, corneal ulcer, despite intense antimicrobial therapy, were treated with PAR. The surgical procedure was deepithelialization of the affected corneas followed by UV-A riboflavin (B2) cross-linking. Local antimicrobial therapy was continued after the procedure. In all cases, the progression of corneal melting was halted after PAR treatment. Emergency keratoplasty was not necessary in any of the 7 eyes presented. More importantly, all the ulcers were healed without significant vascularization. PAR is a promising option for treating patients with therapy-refractory infectious keratitis to avoid emergency keratoplasty and should be considered as a potential adjuvant therapeutic tool in such eyes.