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M. Berra, G. Galperin, I. Berra, G. Boscaro, A. Berra; Treatment of Fungal Keratitis Infection by Fusarium With Corneal Crosslinking. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3908.
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To evaluate the efficacy of Corneal Crosslinking (Riboflavin UV-A). as a single therapy in Fusarium fungal keratitis
12 rabbits were systemic anesthetized and theirs right corneal was inoculated into the stroma in five areas (central, up, bottom, right, left) with 20 ul each inoculation with Fusarium sp (10 (5) UFC/ml), furthermore, right corneas were scratched eight times in a criss-cross pattern with a 30 gauge needle and fifty ul of Fusarium sp (10 (5) UFC/ml), were instilled in the cul-de-sac.Rabbits were divided in two groups: group 1 (G1) with treatment, group 2 (G2) used as a control group.72 hs after infection, G1 were treated with crosslinking associated with Riboflavine. Complete desepithelialization was performed manually in treated corneas, Dextran 0.1% Riboflavin 20% was drop every 5 minutes for 30 minutes and then after checking the equipment's energy (UV 370 nm. Energy 3mW / cm2) irradiation of the stromal bed was started. During this period of time, riboflavine was applied every 5 minutes. Animals of G2 did not received any treatment.96 hours later, the right eyes were evaluated with biomicroscopy, enuclated and sent:1) 6 corneal buttons sent to microbiology, (G1:n=3 and G2:n=3), where they were weighed, corneal rupture was performed in sterile mortar (one for each cornea), cultured in Sabouraud medium agar plate, incubation at 28 ° C for 7 days, count colonies on the six plates.2) 6 corneal buttons sent for histological examination, (G1=3 and G2=3), where hematoxylin-eosin, Pas and Giemsa stainings were performed.
Clinical Evaluation: None of the treated corneas presented slit-lamp appearance of greater infiltration than the ontrol ones at the time of enucleation.Microbiology laboratory: G1: 18.9±15.1 colonies per gr of cornea (col/gr co) and G2 41.8 ±11.2 (col/gr co) (p<0.05)Pathological study: G1: 2/3 corneas showed Fusarium hiphas and inflammatory cells and G3: 3/3 corneas showed Fusarium hiphas and inflammatory cells. Numbers of hyphas and inflammatory cells were higher in G1 than G2
Treatment of fungal keratitis with Corneal Crosslinking (Riboflavin UV-A) appears to be effective in decreasing the intensity and severity of infectious keratitis by Fusarium.We concluded that this therapy may be considered useful as a coadyuvant to the medical treatment or as a resource in resistent infections.
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