Objective UV-A/riboflavin cross-linking (CXL) of corneal collagen fibers is an estab- lished, highly promising therapy for corneal melting in physician-based ophthalmol- ogy. A prospective pilot study was conducted to demonstrate proof of principle of this novel method for the treatment of melting corneal ulcers in dogs and cats.
Procedures After obtaining owner consent, CXL was performed in three cats and three dogs with corneal melting, which either affected the entire corneal surface or was resistant to conventional antibiotic and anticollagenolytic therapy, or affected parts or all of the corneal surface. Medical therapy was continued in all patients. The available follow-up ranged from 2 to 22.5 months and involved slit-lamp examination, fluores- cein staining, and photographic documentation during all rechecks.
Results Surgical stabilization of the cornea was not necessary in any case, because pro- gression of corneal melting was arrested in all cases within 1–20 days of CXL treat- ment. Corneal re-epithelization occurred within 7–40 days in all eyes. At 40 days after CXL, all eyes presented a quiescent corneal state without signs of active inflammation and with beginning scar formation. The complications observed in three of the six animals included a corneal sequestrum, superficial corneal stromal pigmentation, and bullous keratopathy.
Conclusions This study shows the feasibility of CXL to treat progressive corneal melting in veterinary patients. CXL may represent a cost-efficient and safe alternative therapy in the treatment for corneal melting in veterinary ophthalmology. More inves- tigations comparing the effectivity and complication rate of CXL to those of standard medical treatment are necessary.