{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T13:41:26Z","timestamp":1783690886554,"version":"3.55.0"},"reference-count":27,"publisher":"SLACK, Inc.","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Refract Surg"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:sec><jats:title>PURPOSE:<\/jats:title><jats:p>To examine the clinical characteristics, treatments, and prognosis of all cases of infectious keratitis resistant to conventional therapy and treated by photo-activated chromophore for keratitis corneal cross-linking (PACK-CXL) in one institution between 2012 and 2016.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>A database search of patients who underwent PACK-CXL (ultraviolet-A for 10 minutes for irradiance of 9 mW\/cm<jats:sup>2<\/jats:sup>) for infectious keratitis unresponsive to medical treatment at a tertiary care hospital was conducted. The following parameters were documented: patient demographic information, corrected distance visual acuity (CDVA) before the procedure and at the end of follow-up, characteristics of the ulcer, antibiotic treatment prior to CXL, culture results, and long-term complications. Cases with less than 1 year of follow-up were excluded.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>PACK-CXL was performed in 18 consecutive eyes. CDVA at the time of presentation was 1.47 logMAR (mean 1.47 \u00b1 0.72 logMAR, range: 0.00 to 2.79 logMAR). Culture results were positive in 72% of eyes (13 of 18 patients) and no pathogens were identified in 28% of eyes (5 of 18 patients). All patients were treated with more than one antibiotic. The mean CDVA at the end of follow-up was 1.22 logMAR (mean: 1.22 \u00b1 0.89 logMAR, range: 0 to 2.07 logMAR). There was no significant change between CDVA at presentation to CDVA at the end of follow-up (matched pair,<jats:italic>P<\/jats:italic>= .126). One eye underwent an emergency therapeutic penetrating keratoplasty.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>Patients with large, central corneal ulcer and poor CDVA who were resistant to conventional treatment underwent PACK-CXL. At the end of follow-up, only one eye required emergency penetrating keratoplasty. This low rate might be attributed to a good response to CXL.<\/jats:p><jats:p><jats:bold>[<jats:italic>J Refract Surg.<\/jats:italic>2018;34(8):559\u2013563.]<\/jats:bold><\/jats:p><\/jats:sec>","DOI":"10.3928\/1081597x-20180705-01","type":"journal-article","created":{"date-parts":[[2018,8,8]],"date-time":"2018-08-08T19:38:35Z","timestamp":1533757115000},"page":"559-563","source":"Crossref","is-referenced-by-count":14,"title":["Does PACK-CXL Change the Prognosis of Resistant Infectious Keratitis?"],"prefix":"10.3928","volume":"34","author":[{"given":"Ofira","family":"Zloto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina S.","family":"Barequet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alon","family":"Weissman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orit","family":"Ezra Nimni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoav","family":"Berger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noa","family":"Avni-Zauberman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2308","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.3928\/1081597X-20090813-08"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrs.2007.07.028"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9394(02)02220-1"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0886-3350(03)00407-3"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0b013e318156caf2"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0b013e318169d698"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.3928\/1081597X-20090813-11"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/112067210901900221"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0b013e3181d2de91"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.5301\/ejo.5000330"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.3928\/1081597X-20140609-01"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/ICU.0000000000000248"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0000000000000550"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00417-011-1754-1"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2015.03.024"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.16-20110"},{"key":"e_1_3_2_18_2","first-page":"1549","article-title":"Corneal collagen cross-linking and liposomal amphotericin B combination therapy for fungal keratitis in rabbits","volume":"9","author":"Hao ZQ","year":"2016","unstructured":"Hao ZQ, Song JX, Pan SY, et al. 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