Purpose: 

We recently showed the positive clinical effects of combining accelerated corneal cross-linking (PACK-CXL) with antibiotic treatment in patients with presumed bacterial keratitis. In this study, we compare the impacts of a combined PACK-CXL/standard antibiotic treatment (PACK-ABX group) with standard antibiotic treatment alone (ABX group) in patients with culture-confirmed bacterial keratitis.

Methods: 

We reviewed patients with moderate and severe bacterial keratitis and confirmed bacterial cultures. Clinical outcomes were compared for standard antibiotic treatment alone, before the initiation of PACK-CXL, and after adjuvant use of PACK-CXL.

Results: 

A total of 47 eyes of 47 patients were included: 26 eyes in the PACK-ABX group and 21 eyes in the ABX group. Pathogens, baseline demographics (besides age), and clinical parameters were similar between the 2 groups. The PACK-ABX patients had better final uncorrected visual acuity [mean difference 0.57 Logarithm of the Minimum Angle of Resolution, 95% Confidence Interval (CI): 0.16–0.99, P = 0.07] and best-corrected visual acuity (mean difference 0.70 Logarithm of the Minimum Angle of Resolution, 95% CI: 0.23–1.16, P = 0.04), shorter reepithelialization time (mean difference 9.63 days, 95% CI: 3.14–16.12, P = 0.004), and reduced number of clinic visits (mean difference 4.8 meetings, 95% CI: 1.4–8.2, P = 0.007) and need for tectonic grafts (0 vs. 33.3%, P = 0.002). A multivariate analysis controlling for age, sex, ulcer size, and Gram stain showed that PACK-ABX treatment remained significantly associated with reepithelialization time (β = 14.5, P = 0.001).

Conclusions: 

In our study, PACK-CXLs addition to the standard of care in cases of culture-proven bacterial keratitis had a positive effect on the final visual acuity and time to resolution, compared with the standard-of-care treatment.

中文翻译：

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PACK 交联作为辅助治疗可改善培养证实的细菌性角膜炎的临床结果

目的： 

我们最近展示了加速角膜交联(PACK-CXL) 与抗生素治疗相结合对疑似细菌性角膜炎患者的积极临床效果。在本研究中，我们比较了 PACK-CXL/标准抗生素联合治疗（PACK-ABX 组）与单独标准抗生素治疗（ABX 组）对培养确诊的细菌性角膜炎患者的影响。

方法： 

我们回顾了患有中度和重度细菌性角膜炎的患者并证实了细菌培养。比较单独使用标准抗生素治疗、开始 PACK-CXL 之前和辅助使用 PACK-CXL 后的临床结果。

结果： 

共纳入 47 名患者的 47 只眼：PACK-ABX 组 26 只眼，ABX 组 21 只眼。两组之间的病原体、基线人口统计数据（除年龄外）和临床参数相似。PACK-ABX 患者的最终未矫正视力[平均差 0.57 最小分辨率对数，95% 置信区间 (CI)：0.16–0.99，P = 0.07] 和最佳矫正视力（平均差 0.70 对数）更好最小分辨率角度的改善，95% CI：0.23–1.16，P = 0.04），更短的再上皮化时间（平均差异 9.63 天，95% CI：3.14–16.12，P = 0.004），以及减少就诊次数（平均差异差异 4.8 次会议，95% CI：1.4–8.2，P = 0.007），并且需要构造移植（0 vs. 33.3%，P = 0.002）。控制年龄、性别、溃疡大小和革兰氏染色的多变量分析表明，PACK-ABX 治疗仍然与上皮再生时间显着相关（β = 14.5，P = 0.001）。

结论： 

在我们的研究中，与标准护理治疗相比，在培养证明的细菌性角膜炎病例中，除了标准护理之外，PACK-CXL 对最终视力和恢复时间有积极影响。