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Photo-Activated Riboflavin Therapy of Refractory Corneal Ulcers

Panda, Anita MD, FAMS, FICS; Krishna, Sasikala N. DOMS; Kumar, Sandeep MS

doi: 10.1097/ICO.0b013e31823f8f48

Purpose: To evaluate the therapeutic effect of photo-activated riboflavin (PAR) for treating refractory corneal ulcers.

Methods: Seven eyes with infectious keratitis, presented with a gradually deteriorating, vision-threatening, corneal ulcer, despite intense antimicrobial therapy, were treated with PAR. The surgical procedure was deepithelialization of the affected corneas followed by UV-A riboflavin (B2) cross-linking. Local antimicrobial therapy was continued after the procedure.

Results: In all cases, the progression of corneal melting was halted after PAR treatment. Emergency keratoplasty was not necessary in any of the 7 eyes presented. More importantly, all the ulcers were healed without significant vascularization.

Conclusion: PAR is a promising option for treating patients with therapy-refractory infectious keratitis to avoid emergency keratoplasty and should be considered as a potential adjuvant therapeutic tool in such eyes.

*Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences; New Delhi, India

ESI Postgraduate Institute of Medical Science & Research, New Delhi, India.

Reprints: Professor Anita Panda, Cornea & OSD Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India (e-mail:

The authors state that they have no funding or conflicts of interest to disclose.

The authors state that they have no proprietary interest in the products named in this article.

Received June 14, 2011

Accepted August 29, 2011

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.