International Ophthalmology · 6 authors, 3 centres
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This experimental rabbit study found that performing corneal cross-linking (PACK-CXL) six weeks before inducing a bacterial corneal infection resulted in less severe inflammation and prevented corneal melting compared to eyes without prior cross-linking.
This prospective experimental study used 10 rabbits to evaluate if the mechanical effect of corneal cross-linking (PACK-CXL) alone, performed 6 weeks prior to infection, could localize a bacterial keratitis. Keratitis was induced with Pseudomonas aeruginosa or Staphylococcus aureus in eyes that had undergone prior cross-linking versus control eyes. Clinical scoring showed control eyes developed severe inflammation, while cross-linked eyes had markedly decreased manifestations. Notably, corneal melting occurred in 6 control eyes but in none of the cross-linked eyes. Histopathology confirmed that inflammation was confined to the superficial stroma in cross-linked eyes, whereas control eyes showed deep infiltration. The study concludes that the long-term mechanical strengthening from PACK-CXL increases corneal resistance to enzymatic digestion, localizing infection even without an active antimicrobial effect. Limitations include the lack of microbiological evaluation of bacterial burden (colony-forming units).
