Photoactivated Chromophore for Moderate to Severe Infectious Keratitis as an Adjunct Therapy: A Randomized Controlled Trial.

PURPOSE: To evaluate the efficacy of photoactivated chromophore for infectious keratitis (PACK-CXL) in the treatment of patients with moderate to severe infectious keratitis as adjunct therapy to the topical medication treatment.

DESIGN: Randomized clinical trial.

METHODS: Thirty eyes from 30 patients with moderate to severe infectious keratitis were randomized to receive either standard treatment plus PACK-CXL (n = 15) or standard treatment alone (control group, n = 15). The primary outcome was the sizes of stromal infiltrates measured on slit-lamp photographs 30 days after treatment. The secondary outcomes were the sizes of epithelial defects, the complication rates, and best pinhole-corrected visual acuity (BPVA).

RESULTS: The median (interquartile range [IQR]) sizes of stromal infiltrates at day 30 were 5.0 mm(2) (0-23.0 mm(2)) in the PACK-CXL group and 10.6 mm(2) (1.1-16.3 mm(2)) in the control group (median difference 0, 95% CI -7.0 to 0, P = .66). The median (IQR) sizes of epithelial defects were 0.7 mm(2) (0-6.3 mm(2)) and 4.6 mm(2) (0-10.2 mm(2)) in the PACK-CXL group and control group, respectively (median difference -3.0, 95% CI -0.8 to 0, P = .41). The complication rates and BPVA after treatment were comparable between groups.

CONCLUSIONS: Standard treatment combined with PACK-CXL did not provide any advantageous effect over standard treatment alone in moderate to severe infectious keratitis over a 30-day period.