Abstract：
OBJECTIVE: To present the 7-year experience of a tertiary eye hospital while exploring possible risk factors and incidence of infectious keratitis in patients undergoing standard corneal cross-linking (CXL).
METHODS: This retrospective cohort study included patients with progressive keratoconus undergoing standard CXL in the Farabi Eye Hospital and all other patients who had undergone CXL in other facilities and were diagnosed as having infectious keratitis in the 7-year period of the study.
RESULTS: Among the total of 4,863 eyes that underwent CXL, 6 eyes developed infectious keratitis, yielding an incidence rate of 0.12%. Additionally, 13 eyes from 10 patients with a CXL history in other facilities who developed infectious keratitis were included. The mean age was 23.75 years, and 75% of patients were men and 25% were women. Gram-positive bacteria and Staphylococcus aureus were the most prevalent pathogens. Meibomian gland dysfunction, dry eye disease, or blepharitis were present in 12 patients. Medical treatment did not arrest the disease progress in 5 patients, which eventually required cases to undergo keratoplasty.
CONCLUSIONS: This study supports the need for proper patient selection by using a comprehensive medical history. It also highlights the imperative role of rigorous patient education and follow-up, particularly in the first postoperative week. Finally, the study emphasizes aggressive early therapy for patients with suspicious findings. [J Refract Surg. 2023;39(8):564-572.].
METHODS: This retrospective cohort study included patients with progressive keratoconus undergoing standard CXL in the Farabi Eye Hospital and all other patients who had undergone CXL in other facilities and were diagnosed as having infectious keratitis in the 7-year period of the study.
RESULTS: Among the total of 4,863 eyes that underwent CXL, 6 eyes developed infectious keratitis, yielding an incidence rate of 0.12%. Additionally, 13 eyes from 10 patients with a CXL history in other facilities who developed infectious keratitis were included. The mean age was 23.75 years, and 75% of patients were men and 25% were women. Gram-positive bacteria and Staphylococcus aureus were the most prevalent pathogens. Meibomian gland dysfunction, dry eye disease, or blepharitis were present in 12 patients. Medical treatment did not arrest the disease progress in 5 patients, which eventually required cases to undergo keratoplasty.
CONCLUSIONS: This study supports the need for proper patient selection by using a comprehensive medical history. It also highlights the imperative role of rigorous patient education and follow-up, particularly in the first postoperative week. Finally, the study emphasizes aggressive early therapy for patients with suspicious findings. [J Refract Surg. 2023;39(8):564-572.].
摘要：
目的：介绍三级眼科医院7年的经验，同时探讨标准角膜交联（CXL）患者感染性角膜炎的可能危险因素和发生率。
方法：这项回顾性队列研究包括在Farabi眼科医院接受标准CXL治疗的进行性圆锥角膜患者和在其他设施接受CXL治疗的所有其他患者，并在7年的研究期间被诊断为感染性角膜炎。
结果：在接受CXL的4,863只眼中，6只眼出现感染性角膜炎，发病率为0.12%。此外,包括来自10名在其他设施中发展为感染性角膜炎的CXL病史患者的13只眼。平均年龄是23.75岁,75%的患者为男性，25%为女性。革兰阳性菌和金黄色葡萄球菌是最常见的病原菌。睑板腺功能障碍,干眼症,12例患者出现了眼睑炎。药物治疗未阻止5例患者病情进展，最终需要病例进行角膜移植术。
结论：本研究通过使用综合病史来支持适当选择患者的需要。它还强调了严格的患者教育和随访的当务之急，特别是在术后第一周。最后,该研究强调对发现可疑的患者进行积极的早期治疗。[JRefractSurg.2023年；39（8）：564-572。].
方法：这项回顾性队列研究包括在Farabi眼科医院接受标准CXL治疗的进行性圆锥角膜患者和在其他设施接受CXL治疗的所有其他患者，并在7年的研究期间被诊断为感染性角膜炎。
结果：在接受CXL的4,863只眼中，6只眼出现感染性角膜炎，发病率为0.12%。此外,包括来自10名在其他设施中发展为感染性角膜炎的CXL病史患者的13只眼。平均年龄是23.75岁,75%的患者为男性，25%为女性。革兰阳性菌和金黄色葡萄球菌是最常见的病原菌。睑板腺功能障碍,干眼症,12例患者出现了眼睑炎。药物治疗未阻止5例患者病情进展，最终需要病例进行角膜移植术。
结论：本研究通过使用综合病史来支持适当选择患者的需要。它还强调了严格的患者教育和随访的当务之急，特别是在术后第一周。最后,该研究强调对发现可疑的患者进行积极的早期治疗。[JRefractSurg.2023年；39（8）：564-572。].
