accelerated cxl for the treatment of infectious keratitis
TRANSCRIPT
ACCELERATED-CXL FOR THE
TREATMENT OF INFECTIOUS
KERATITIS
Lessons from animal studies
Dr Frank FAMOSE
DVM – DESV ophtalmologie
Toulouse - France
[email protected] 2014
Avedro’s 3rd International Congress on Advanced Corneal Cross-Linking
Surgical
treatment
Medical
treatment
Success
Failure
Conjunctival
graftsEnucleation
Visual loss
Antibiotics
Anticollagenases…
Observance
Evolution of infectious keratitis in dogs & cats
Unmet needs…Single treatment
High rate of success
Light post-op Tt
Vision preservation
Background
StandardProtocol30min 3mW/cm²
Inclusion criteria
Dogs and cats
Corneal melting
Poor response to
medical treatment
Minimal corneal thickness>300 µm
Protocol
General
anesthesia
Corneal
cleaning
Riboflavine
soaking
Exposition
UVA 365 nm
Post-CXL
treatment
OCT
Medetomidine
Ketamine
Isoflurane
Debris removal
Bact. sampling
PCR (FHV1)
RF 0,1% 20% dextran
(VibexTM)
1 drop ev. 2 min
30 minutes
30 mW/cm²
3 min
5,4J/cm²
TobrexTM BID
7 days
Accelerated protocol
(KXLTM – Avedro)
Results
8 Dogs* 10 Cats**
No adverse reaction *Famose F. Veterinary ophthalmology 2013** Famose F. Veterinary ophtalmology 2013
Corneal infiltration
D1 D8
8/8 dogs – 10/10 cats 0/8 dogs – 0/10 cats
Corneal vascularization
D1 D31
8/8 dogs – 10/10 cats 2/8 dogs – 3/10 cats
Corneal vascularization
D1 D31
8/8 dogs – 10/10 cats 2/8 dogs – 3/10 cats
Corneal scar
D1 D31
8/8 dogs – 10/10 cats
Corneal scar
D1 D31
8/8 dogs – 10/10 cats
Accelerated CXL
Single treatment with high rate of
success
Vision preservation
No specialized technical skills
Shortening of procedure duration
Are antibioticsstill necessary after CXL?
Could CXL be a first
intention treatment ?
Could we use
higher fluences?
Could we use
Iontophoresis?
Thank you.