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UVA-riboflavin photochemical therapy of bacterial keratitis: a pilot study
Department of Ophthalmology, Örebro University Hospital, Örebro, Sweden.
Department of Ophthalmology, Örebro University Hospital, Örebro, Sweden; Department of Ophthalmology, Ryhov County Hospital, Jönköping, Sweden.
Department of Ophthalmology, Ryhov County Hospital, Jönköping, Sweden.
Department of Infectious Medicine, Futurum, the Academy of Health, Ryhov County Hospital, Jönköping, Sweden; Department of Infectious Medicine, Institution of Clinical and Experimental Medicine, University of Linköping, Linköping, Sweden.
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2012 (English)In: Graefe's Archives for Clinical and Experimental Ophthalmology, ISSN 0721-832X, E-ISSN 1435-702X, Vol. 250, no 1, p. 95-102Article in journal (Refereed) Published
Abstract [en]

Background: The aim of this work as to investigate the photochemical interaction used in corneal crosslinking (CXL) as the primary therapy for bacterial keratitis.

Methods: A prospective non-randomized study was conducted including 16 patients with a clinical diagnosis of bacterial keratitis. No patient had any prior antibiotic treatment for the current infection. Photography and microbial culturing of the infected cornea were performed. Riboflavin was topically administered for 20 min and ultraviolet light (UVA) exposure settings for treatment of keratoconus were used. After the procedure, clinical examinations were done at least once daily until signs of improvement had been established. The frequency of examinations was thereafter reduced. Antibiotic therapy was initiated if infectious progression was suspected. The trial was registered at ISCRTN.org (no: 21432643).

Results: All eyes responded to the photochemical treatment with improvement in symptoms and signs of reduced inflammation. Epithelial healing was achieved in all cases. Antibiotic administration was necessary in two cases. One patient required a human amniotic membrane transplant.

Conclusions: This trial illustrates that photosensitization of riboflavin using UVA at 365 nm has the potential to induce healing in patients with microbial keratitis. The results from the treatment of these 16 patients with corneal ulcers indicate that UVA-riboflavin photochemical therapy merits a controlled study in order to assess its efficacy and safety compared to antibiotics.

Place, publisher, year, edition, pages
New York, USA: Springer, 2012. Vol. 250, no 1, p. 95-102
Keywords [en]
UV, UVA, ultraviolet, riboflavin, CXL, keratitis, pilot study
National Category
Surgery Medical and Health Sciences
Research subject
Surgery; Medicine
Identifiers
URN: urn:nbn:se:oru:diva-20752DOI: 10.1007/s00417-011-1754-1ISI: 000299371000012PubMedID: 21874347Scopus ID: 2-s2.0-84857359468OAI: oai:DiVA.org:oru-20752DiVA, id: diva2:474406
Note

Funding Agencies:

Örebro University Hospital (Sweden) OLL-57221

Futurum, the Academy of Health Care, Jonkoping (Sweden)

Available from: 2012-01-09 Created: 2012-01-09 Last updated: 2018-05-08Bibliographically approved
In thesis
1. Ultraviolet light A (UVA) photoactivation of riboflavin as a potential therapy for infectious keratitis
Open this publication in new window or tab >>Ultraviolet light A (UVA) photoactivation of riboflavin as a potential therapy for infectious keratitis
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2011. p. 70
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 63
National Category
Medical and Health Sciences Surgery
Research subject
Surgery
Identifiers
urn:nbn:se:oru:diva-20130 (URN)978-91-7668-834-2 (ISBN)
Public defence
2011-12-16, Wilandersalen, Universitetssjukhuset, Örebro, 09:15 (Swedish)
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Supervisors
Available from: 2011-10-20 Created: 2011-10-20 Last updated: 2017-10-17Bibliographically approved

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Makdoumi, KarimCrafoord, Sven

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