Crosslinking as a treatment for infectious crystalline keratopathy
Infectious crystalline keratopathy (ICK) is a rare cornea disease, manifested by gray-and-white tree-like or needle-like stromal opacities with minimal signs of inflammation. The disease is caused by the colonization of microorganisms on the corneal stroma and their formation of biofilms, making the...
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| Format: | Article |
| Language: | Russian |
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Real Time Ltd
2022-03-01
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| Series: | Российский офтальмологический журнал |
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| Online Access: | https://roj.igb.ru/jour/article/view/897 |
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| author | S. V. Trufanov I. A. Riks S. S. Papanyan M. Ezugbaya R. Boutaba |
| author_facet | S. V. Trufanov I. A. Riks S. S. Papanyan M. Ezugbaya R. Boutaba |
| author_sort | S. V. Trufanov |
| collection | DOAJ |
| description | Infectious crystalline keratopathy (ICK) is a rare cornea disease, manifested by gray-and-white tree-like or needle-like stromal opacities with minimal signs of inflammation. The disease is caused by the colonization of microorganisms on the corneal stroma and their formation of biofilms, making them extremely resistant to treatment with antibiotics and to the immune response of the patient. Typically, the most important risk factor for ICK development is the presence of an immunodeficiency cornea condition with long-term topical steroid therapy, which is normally prescribed after keratoplasty. Two clinical cases of ICK are discussed in which the reduction of topical glucocorticoids and the intensive use of antibiotics did not result in positive clinical changes. Only after an accelerated crosslinking procedure (PACK-CXL), needlelike opacities disappeared in the area of microbial invasion and signs of infiltration appeared, indicating the restoration of the local immune response. This phenomenon is likely due to the destruction of the biofilm and the microbial agents themselves, which afterwards contributed to a more effective impact of the antibacterial drug. This combined treatment led to resorption of the inflammatory focus with the formation of local opacification. The effectiveness of PACK-CXL in infectious processes is explained by the effects of both riboflavin and ultraviolet radiation. No literature references on the use of cross-linking in the treatment of ICK are available. In our opinion, cross-linking in early ICK patients after keratoplasty is justified by the inability, in some cases, to completely discontinue glucocorticosteroid therapy, as this will greatly increase the chances of rejection and graft jailure. PACK-CXL can be an effective way of destroying the biofilm in the corneal stroma. |
| format | Article |
| id | doaj-art-b23cc2d60cb54a649d97e2bbc152c66a |
| institution | DOAJ |
| issn | 2072-0076 2587-5760 |
| language | Russian |
| publishDate | 2022-03-01 |
| publisher | Real Time Ltd |
| record_format | Article |
| series | Российский офтальмологический журнал |
| spelling | doaj-art-b23cc2d60cb54a649d97e2bbc152c66a2025-08-20T03:19:24ZrusReal Time LtdРоссийский офтальмологический журнал2072-00762587-57602022-03-0115111712110.21516/2072-0076-2022-15-1-117-121434Crosslinking as a treatment for infectious crystalline keratopathyS. V. Trufanov0I. A. Riks1S. S. Papanyan2M. Ezugbaya3R. Boutaba4Pavlov First Saint Petersburg State Medical UniversityPavlov First Saint Petersburg State Medical UniversityPavlov First Saint Petersburg State Medical UniversityPavlov First Saint Petersburg State Medical UniversityPavlov First Saint Petersburg State Medical UniversityInfectious crystalline keratopathy (ICK) is a rare cornea disease, manifested by gray-and-white tree-like or needle-like stromal opacities with minimal signs of inflammation. The disease is caused by the colonization of microorganisms on the corneal stroma and their formation of biofilms, making them extremely resistant to treatment with antibiotics and to the immune response of the patient. Typically, the most important risk factor for ICK development is the presence of an immunodeficiency cornea condition with long-term topical steroid therapy, which is normally prescribed after keratoplasty. Two clinical cases of ICK are discussed in which the reduction of topical glucocorticoids and the intensive use of antibiotics did not result in positive clinical changes. Only after an accelerated crosslinking procedure (PACK-CXL), needlelike opacities disappeared in the area of microbial invasion and signs of infiltration appeared, indicating the restoration of the local immune response. This phenomenon is likely due to the destruction of the biofilm and the microbial agents themselves, which afterwards contributed to a more effective impact of the antibacterial drug. This combined treatment led to resorption of the inflammatory focus with the formation of local opacification. The effectiveness of PACK-CXL in infectious processes is explained by the effects of both riboflavin and ultraviolet radiation. No literature references on the use of cross-linking in the treatment of ICK are available. In our opinion, cross-linking in early ICK patients after keratoplasty is justified by the inability, in some cases, to completely discontinue glucocorticosteroid therapy, as this will greatly increase the chances of rejection and graft jailure. PACK-CXL can be an effective way of destroying the biofilm in the corneal stroma.https://roj.igb.ru/jour/article/view/897infectious crystalline keratopathyfungibacteriacross-linkingpack-cxlepithelium defectkeratoplastykeratitiscornea |
| spellingShingle | S. V. Trufanov I. A. Riks S. S. Papanyan M. Ezugbaya R. Boutaba Crosslinking as a treatment for infectious crystalline keratopathy Российский офтальмологический журнал infectious crystalline keratopathy fungi bacteria cross-linking pack-cxl epithelium defect keratoplasty keratitis cornea |
| title | Crosslinking as a treatment for infectious crystalline keratopathy |
| title_full | Crosslinking as a treatment for infectious crystalline keratopathy |
| title_fullStr | Crosslinking as a treatment for infectious crystalline keratopathy |
| title_full_unstemmed | Crosslinking as a treatment for infectious crystalline keratopathy |
| title_short | Crosslinking as a treatment for infectious crystalline keratopathy |
| title_sort | crosslinking as a treatment for infectious crystalline keratopathy |
| topic | infectious crystalline keratopathy fungi bacteria cross-linking pack-cxl epithelium defect keratoplasty keratitis cornea |
| url | https://roj.igb.ru/jour/article/view/897 |
| work_keys_str_mv | AT svtrufanov crosslinkingasatreatmentforinfectiouscrystallinekeratopathy AT iariks crosslinkingasatreatmentforinfectiouscrystallinekeratopathy AT sspapanyan crosslinkingasatreatmentforinfectiouscrystallinekeratopathy AT mezugbaya crosslinkingasatreatmentforinfectiouscrystallinekeratopathy AT rboutaba crosslinkingasatreatmentforinfectiouscrystallinekeratopathy |