Therapeutic Effect of Corneal Crosslinking on Fungal Keratitis: Efficacy of Corneal Collagen Crosslinking as an Adjuvant Therapy for Fungal Keratitis in a Tertiary Eye Hospital in South India

Purpose To evaluate the efficacy of CXL in treating fungal keratitis as an adjuvant therapy. Methods Detailed clinical examination microbiological investigation was performed. Twenty fungal keratitis patients were recruited and randomized into two groups: group 1 (n= 11, standard antifungal), group 2 (n=9, corneal collagen crosslinking with standard antifungal). Corneal scraping and tear samples collected were subjected to real-time PCR targeting ITS, TLR analysis and cytokine analysis. Results The mean time for complete resolution of ulcer for group 2 was significantly shorter compared to group 1 and the final mean BCVA was better for group 2. Expression of IL-1 beta, IL-8, IFN-gamma significantly decreased immediately post CXL in group 2 patients. Significant downregulation of TLR 6, TLR-3, TLR-4 was observed 3-days post CXL compared to group 1 patients. Conclusion Adjuvant effect of CXL was significant in treating fungal keratitis compared to standalone antifungal treatment.

Automated summary

This study evaluated the efficacy of corneal collagen crosslinking as an adjuvant therapy for fungal keratitis. The results showed that the group receiving CXL in combination with standard antifungal treatment had a significantly shorter time for ulcer resolution, improved final best-corrected visual acuity, and significant changes in cytokine expression.