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-1β, IL-8, IFN-γ 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.
Keywords: Fungal keratitis; adjuvant therapy; corneal collagen crosslinking; cytokines; toll – like receptors.