Evaluation of accelerated collagen cross-linking for the treatment of melting keratitis in ten cats

ObjectivesMelting keratitis is a serious condition presenting a high risk of permanent blindness and is caused by infectious or noninfectious factors. In humans, the clinical efficacy of collagen cross-linking (CXL) has been described in the treatment of refractory infectious keratitis by arresting keratomalacia. The aim of this study was to evaluate the efficacy of accelerated CXL for the treatment of melting keratitis in cats. Animals studiedTen cats were treated for unilateral melting keratitis by accelerated CXL. ProcedureCorneas were irradiated by UVA (370nm) at 30mW/cm(2) irradiance for 3min after soaking with 0.1% riboflavin in 20% dextran for 30min (D1). Follow-up was conducted 3, 7, 14, and 30days after treatment. ResultsPain improvement was noted for all cases at D4 examination. Epithelial healing was observed at D8 for 9 of 10 cases and at D15 for 1 of 10 cases. Resolution of cellular infiltration was observed for all cases at D8 examination. The corneal vascularization was reduced for 9 of 10 cats by D31. At D31, all cases presented a variable degree of corneal fibrosis, but all eyes had visual function. No recurrent infection was observed. ConclusionAccelerated CXL appears to be a valuable option for the treatment of melting keratitis in cats. All the cases have reached a satisfactory outcome despite the individual differences in the conditions prior to the CXL treatment and the variable presence of infectious agents.