Corneal Infection in a Child with Congenital Insensitivity to Pain and Anhidrosis Treated with Accelerated Corneal Cross-Linking: Case Report

Yonit Krakauer, Boris Knyazer, Baker Elsana and Erez Tsumi

Department of Ophthalmology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
Both author contributed equally to this study

^*Correspondance to: Baker Elsana 

 PDF  Full Text DOI: 10.25107/2474-1647.2379

Abstract

Purpose: To report a case of a child with CIPA and a corneal infectious keratitis that did not respond to standard antibiotic treatment and was successfully treated with accelerated Photo Activated Chromophore for Keratitis (PACK-CXL).
Methods: This is a report of an 11-year-old girl with CIPA who presented to the outpatient eye clinic with an active corneal abscess, stromal thinning and hypopyon. Standard antibiotic treatment brought no improvement in her condition and the child was ultimately treated successfully with accelerated PACK-CXL. A literature review summarizes the use of PACK-CXL in the treatment of corneal abscess.
Results: An 11-year-old girl with CIPA presented with a 3 mm active corneal abscess, stromal thinning and hypopyon. She was admitted to hospital and a standard topical antibiotic treatment was started. When no improvement was achieved after 4 days of intensive antibiotic treatment, she underwent accelerated PACK-CXL (UVA light of 30 mW/cm for 3 min for a total dose of 5.4 J/cm2), with improvement of the corneal abscess and resolution of the hypopyon. The patient has been followed for ten years.
Conclusion: PACK-CXL can be a safe and effective adjunct therapy for corneal infectious keratitis in CIPA patients, and for other complicated corneal abscesses that do not respond to conventional, intensive topical treatment in CIPA patients.

Keywords

PACK-CXL; Corneal cross-linking; Neurotrophic keratitis; CIPA; Infectious keratitis

Cite the article

Krakauer Y, Knyazer B, Elsana B, Tsumi E. Corneal Infection in a Child with Congenital Insensitivity to Pain and Anhidrosis Treated with Accelerated Corneal Cross-Linking: Case Report. Clin Surg. 2019; 4: 2379.