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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. 1 Department of Ophthalmology, Provincial Hospital affiliated to Shandong University, Jinan, China
  2. 2 Department of Visual Sciences and Ophthalmology, the Chinese University of Hong Kong, Kowloon, Hong Kong
  3. 3 Centre for Eye Research Australia, University of Melbourne, Australia
  4. 4 Clinical 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}

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Collagen crosslinking (CXL) has been used to treat cases with bacterial, Acanthamoeba 1 ,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.


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, total dose 5.4 J/cm2). Riboflavin administration was …

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  • Contributors Concept and design: ZL and VJ. Analysis and interpretation: ZL and VJ. Writing the article: ZL, VJ, XT, HY, WC and GM. Critical revision of the article: ZL and VJ. Final approval of the article: ZL, VJ, XT, HY, WC and GM. Data collection: ZL. Provision of materials, patients or resources: ZL, XT, HY, WC and GM. Statistical expertise: ZL and VJ. Obtaining funding: ZL and GM. Literature search: ZL and VJ.

  • Funding This study was supported by the Natural Science Foundation of Shandong Province (ZR2012HM008).

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval The ethic committee of the Provincial Hospital affiliated to Shandong University.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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