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Riboflavin/ultravoilet light-mediated crosslinking for fungal keratitis
  1. Zhiwei Li1,
  2. Vishal Jhanji2,3,
  3. Xiangchen Tao1,
  4. Haiqun Yu1,
  5. Wei Chen4,
  6. Guoying Mu1
  1. 1Department of Ophthalmology, Provincial Hospital affiliated to Shandong University, Jinan, China
  2. 2Department of Visual Sciences and Ophthalmology, the Chinese University of Hong Kong, Kowloon, Hong Kong
  3. 3Centre for Eye Research Australia, University of Melbourne, Australia
  4. 4Clinical College of Ophthalmology, Tianjin Medical Univeristy, Tianjin, China
  1. Correspondence to Dr Guoying Mu, Department of Ophthalmology, Provincial Hospital affiliated to Shandong University, No. 324, Jing 5 Road, Ji'nan City, Shandong Province, P. R. China, 250021; mgyeyes{at}yahoo.com.cn

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Introduction

Collagen crosslinking (CXL) has been used to treat cases with bacterial, Acanthamoeba1 ,2 and fungal keratitis2 with encouraging results. In this study, we present the clinical outcomes in cases with fungal keratitis that received riboflavin/ultravoilet light A (UVA) light-mediated crosslinking.

Methods

Patients with microbiologically proven fungal keratitis were included in this study. A written consent was obtained from all the patients. The study protocol was approved by the ethics committee of the Provincial Hospital. Initial treatment was commenced in the form of hourly 5% natamycin eye drops and 0.3% tobramycin eye drops four times a day. A decision was taken to perform CXL after no response to treatment or an exacerbation of infection was observed. Under topical anaesthesia, the epithelium surrounding the infiltrate was removed. Riboflavin (Medio-Cross riboflavin/dextran solution, 0.1%) was administered topically for 30 min at intervals of 2 min. The cornea was illuminated for 30 min using a UV light lamp (UV-X 1000 system, IROC Innocross AG Co, Switzerland; wavelength 365 nm, irradiance 3 mW/cm2, …

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