PACK-CXL in Reducing the Time to Heal in Suppurative Corneal Ulcers: Observations of a Pilot Study From South India.

PURPOSE: To assess the usefulness of photoactivated chromophore for infectious keratitis-corneal collagen cross-linking in reducing the time to heal in suppurative corneal ulcers in a South Indian tertiary care center. METHODS: This was an observational cohort study with 2 arms. In the prospective arm, 13 patients with suppurative corneal ulcers who presented to the outpatient department were recruited. Their ulcers were exposed to ultraviolet-A with riboflavin (B2) (photoactivated chromophore for infectious keratitis-corneal collagen cross-linking) up to a maximum of 4 sittings at 3-day intervals. Topical antimicrobial therapy was continued as per the standard department protocol. This cohort was compared with a retrospective cohort of 32 consecutive patients who had been admitted and treated at our department for a similar profile of ulcers in the previous 1 year. RESULTS: The ulcers in the prospective arm had an average healing time of 21.6 days, whereas the retrospective arm had an average healing time of 48.8 days. This reduction in the time to heal trends not only toward being statistically significant (P = 0.06) but also highly clinically significant. CONCLUSIONS: CXL reduced the time to heal in suppurative corneal ulcers less than 6 mm in diameter and can be used as an adjuvant to antimicrobial therapy.