Bacterial Keratitis, Fungal Keratitis
Conditions
Keywords
Infectious keratitis, Corneal cross linking, Topical antibiotics
Brief summary
The corneal collagen cross linking is currently used in the treatment of keratoconus but this procedure has also a sterilizing non-specific effect on bacteria and fungus. So the corneal cross linking in association with the antibiotic treatment could result in a reduction of the duration of epithelial complete healing of the cornea.
Interventions
DEVICECrosslinking
The procedure of the cross linking is standard:combined riboflavin(Ricrolin®)-ultraviolet type A rays (UVA) collagen cross-linking. Radiant energy was 3 milliwatts/cm2 or 5.4 joule/cm2 for a 30-minute exposure irradiation of the cornea. Patients are checked every days during the hospitalisation and one week, one month and 3 months after the hospitalisation.
If not the contact lens wearer -\> Cocci Gram positive cocci * Vancomycin + Fortum If contact lens wearer -\> Gram negative bacillus * Fortum + Amiklin If corticosteroids, immunosuppression, latent evolution -\> Fungus. = Fortum + vancomycin + Fungizone
Sponsors
Nantes University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Infectious bacterial or fungal keratitis with : size \> 2mm or within the central corneal area ( 3mm of the visual axis ) or with a reaction in anterior chamber. * Being major responsible. * Agreement in writing to participate in the study. * Being affiliated to a national insurance scheme.
Exclusion criteria
* Present an infectious keratitis without all the previous criteria. * Herpes or acanthamoeba keratitis * preperforated or perforated cornea. General criteria: * Pregnant woman. * Minors(miners). * Adults under guardianship. * Patient can not be followed during 3 necessary months. * French speaking patient. * Unaffiliated patient in a national insurance scheme. * HIV infected patients
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Duration of corneal complete epithelial healing in days. | 3 months |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Size of the corneal scar | 3months | Size of the corneal scar at 3months expressed in % of the initial size of the corneal ulcer. |
| Corneal thinning | 3 months | Corneal thinning estimated by Anterior segment optical coherence tomography at 3 months, expressed in microns. |
| Gain of visual acuity | 3 months | Gain of visual acuity, corresponding to the difference between the initial visual acuity and the 3months one. The visual acuity is measured with monoyer scale and converted in log Mar. |
Countries
France
Outcome results
None listed