الفهرس 
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Abstract
Corneal infections are sight-threatening and remain to be a
challenge for the ophthalmologist, especially if the infection
resists medical treatment or complicates with corneal stromal
melting.
Corneal collagen cross-linking (CXL) is a relatively new
technique of strenghthening corneal stroma that showed good
results in cases of corneal ectatic conditions. There have been
several trials of using this technique in combating corneal
infections with variable results.
This prospective clinical trial investigated the efficacy and
safety of CXL with photoactivated riboflavin in the managementof infectious keratitis with corneal melting. Forty eyes from 40
patients with advanced infectious keratitis and coexisting corneal
melting. Twenty-one patients (21 eyes) underwent CXL
treatment in addition to antimicrobial therapy. The control group
consisted of 19 patients (19 eyes) who received only
antimicrobial therapy.
The slit-lamp characteristics of the corneal ulceration,
corrected distance visual acuity, duration until healing, and
complications were documented in each group. The Mann-
Whitney U test was used for statistical analysis. P values less than
0.05 were considered statistically significant.
The average time until healing was 39.76±18.22 days in
the CXL group and 46.05±27.44 days in the control group (P =
0.68). After treatment and healing, corrected distance visual
acuity was 1.64±0.62 in the CXL group and 1.67±0.48 in the
control group (P = 0.68). The corneal ulceration’s width andlength was significantly bigger in the CXL group (P = 0.004 and
P = 0.007). Three patients in the control group demonstrated
corneal perforation; infection recurred in 1 of them. No serious
complications occurred in the CXL group.
The results show that CXL with photoactivated riboflavin
did not shorten the time to corneal healing; however, the
complication rate was 21% in the control group, whereas there
was no incidence of corneal perforation or recurrence of the
infection in the CXL group. These results indicate that CXL may
be an effective adjuvant therapy in the management of severe
infectious keratitis associated with corneal melting.