In order assess the time to corneal epithelization with photoactivated chromophore for infectious keratitis-corneal cross-linking (PACK-CXL) as a first-line treatment for early infectious corneal ulcers and to compare PACK-CXL with antimicrobial therapy, the current standard of care, instigators conducted a prospective, interventional, multicenter, randomized phase III clinical trial. Corneal re-epithelization times were compared between patients with infiltrates and early ulcers up to 4 mm in diameter and 300 μm deep who were randomized to PACK-CXL or antimicrobials. No differences in re-epithelization were seen between the antimicrobial and PACK-CXL groups, with a median time to epithelization of 7 days forth both. However, 89% of eyes treated with PACK-CXL healed without the use of antimicrobial therapy, even with a tendency for longer healing than seen in the antimicrobial group, in which 93% of eyes healed with the use of antimicrobials. PACK-CXL could prove particularly useful in treating drug-resistant pathogen, said the presenting study author.
