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

PurposeTo 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.DesignRandomized clinical trial.MethodsThirty 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).ResultsThe median (interquartile range [IQR]) sizes of stromal infiltrates at day 30 were 5.0 mm2 (0-23.0 mm2) in the PACK-CXL group and 10.6 mm2 (1.1-16.3 mm2) 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 mm2 (0-6.3 mm2) and 4.6 mm2 (0-10.2 mm2) 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.ConclusionsStandard 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.